Provider Demographics
NPI:1114009412
Name:GETZOFF, I. HARVEY (DC)
Entity Type:Individual
Prefix:
First Name:I.
Middle Name:HARVEY
Last Name:GETZOFF
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 1:11 WEST MAIN ST
Mailing Address - Street 2:MARLTON CHIRO CTR
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-2029
Mailing Address - Country:US
Mailing Address - Phone:856-983-0009
Mailing Address - Fax:856-983-2336
Practice Address - Street 1:11 WEST MAIN ST
Practice Address - Street 2:MARLTON CHIRO CTR
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-2029
Practice Address - Country:US
Practice Address - Phone:856-983-0009
Practice Address - Fax:856-983-2336
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00136500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
22-2212642OtherTAX ID
025239Medicare PIN