Provider Demographics
NPI:1588100531
Name:MAURICE CAMPANELLI DC INC
Entity type:Organization
Organization Name:MAURICE CAMPANELLI DC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MAURICE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPANELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-775-6613
Mailing Address - Street 1:257 MONMOUTH RD STE 1A
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-1501
Mailing Address - Country:US
Mailing Address - Phone:732-775-6613
Mailing Address - Fax:
Practice Address - Street 1:257 MONMOUTH RD STE 1A
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755
Practice Address - Country:US
Practice Address - Phone:732-775-6613
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-16
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00470300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty