Provider Demographics
NPI:1043228513
Name:JOHN G GIACALONE CORP
Entity Type:Organization
Organization Name:JOHN G GIACALONE CORP
Other - Org Name:JOHN GIACALONE CORP DBA MOBILITY-DOC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:G
Authorized Official - Last Name:GIACALONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-234-0283
Mailing Address - Street 1:1545 N 9TH ST STE 150
Mailing Address - Street 2:
Mailing Address - City:STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18360-9266
Mailing Address - Country:US
Mailing Address - Phone:570-234-0283
Mailing Address - Fax:570-290-8458
Practice Address - Street 1:1545 N 9TH ST STE 150
Practice Address - Street 2:
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-9266
Practice Address - Country:US
Practice Address - Phone:570-234-0283
Practice Address - Fax:570-290-8458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003545L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ38MC00344600OtherLICENSE/REGISTRATION
PA5102380001OtherCIGNA HEALTH INSURANCE
PA819420OtherFIRST PRIORITY HEALTH INS
PA601757500OtherPA DEPTMENT OF LABOR
NJP2948333OtherOXFORD INSURANCE
PA1505642OtherHYMARKBLUE SHIELD
PA5897700OtherGHI HEALTH INSURANCE
PA5102380001OtherCIGNA HEALTH INSURANCE