Provider Demographics
NPI:1003914623
Name:HENDLEY, MICHAEL SIMON (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:SIMON
Last Name:HENDLEY
Suffix:
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 1:20 N ABERDEEN PL
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08401-3302
Mailing Address - Country:US
Mailing Address - Phone:609-348-3319
Mailing Address - Fax:
Practice Address - Street 1:52 E NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-2380
Practice Address - Country:US
Practice Address - Phone:609-788-3539
Practice Address - Fax:609-788-3582
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00639900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0102296Medicaid
NJ2724753000OtherAMERIHEALTH
NJ010853392OtherBLUE CROSS/BLUE SHIELD