Provider Demographics
NPI:1073693602
Name:CARNEY CHIROPRACTIC CENTER,LLC
Entity Type:Organization
Organization Name:CARNEY CHIROPRACTIC CENTER,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:GOLDWASSER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:410-882-0720
Mailing Address - Street 1:9403 HARFORD RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-3123
Mailing Address - Country:US
Mailing Address - Phone:410-882-0720
Mailing Address - Fax:410-882-6767
Practice Address - Street 1:9403 HARFORD RD
Practice Address - Street 2:SUITE 1
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-3123
Practice Address - Country:US
Practice Address - Phone:410-882-0720
Practice Address - Fax:410-882-6767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01148111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD2135931OtherUNITED HEALTH CARE
MDR268OtherBLUECROSS FEDERAL
MD245561OtherKAISER
MD483053OtherAETNA
MDM293CAOtherBLUECROSS/BLUESHIELD
MD107089OtherJOHNS HOPKINS HEALTH
MD2135931OtherUNITED HEALTH CARE