Provider Demographics
NPI:1043415078
Name:SCORDO, JOSEPH (DC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:SCORDO
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 1:810 HOOPER AVE
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-7719
Mailing Address - Country:US
Mailing Address - Phone:732-281-3200
Mailing Address - Fax:732-276-9885
Practice Address - Street 1:810 HOOPER AVE
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-7719
Practice Address - Country:US
Practice Address - Phone:732-281-3200
Practice Address - Fax:732-276-9885
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000674111N00000X
NJ38MC00649600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1618513OtherFIRST HEALTH NETWORK
DE3530091000OtherBLUE CROSS BLUE SHIELD
DE8008847OtherCIGNA
DE3530091000OtherAMERIHEALTH
V03253Medicare UPIN