Provider Demographics
NPI:1073673117
Name:COFFEY, ANNE E (DC)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:E
Last Name:COFFEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 RAYMOND AVE
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-2128
Mailing Address - Country:US
Mailing Address - Phone:862-368-4056
Mailing Address - Fax:973-338-4849
Practice Address - Street 1:1129 BROAD ST
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003
Practice Address - Country:US
Practice Address - Phone:973-338-3620
Practice Address - Fax:973-338-4849
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00615900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor