Provider Demographics
NPI:1972544658
Name:LOLLIN, CRAIG EUGENE JR (DC)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:EUGENE
Last Name:LOLLIN
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 EQUESTRIAN WAY
Mailing Address - Street 2:
Mailing Address - City:MONROE TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-4084
Mailing Address - Country:US
Mailing Address - Phone:732-605-0818
Mailing Address - Fax:732-940-9513
Practice Address - Street 1:2864 RTE 27
Practice Address - Street 2:SUITE C
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-5010
Practice Address - Country:US
Practice Address - Phone:732-940-9511
Practice Address - Fax:732-940-9513
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00553600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor