Provider Demographics
NPI:1134279672
Name:ANTHONY J. PANZICA, DC, LLC
Entity Type:Organization
Organization Name:ANTHONY J. PANZICA, DC, LLC
Other - Org Name:ANTHONY J. PANZICA, DC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:J
Authorized Official - Last Name:PANZICA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-843-6266
Mailing Address - Street 1:11 S FARVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-2607
Mailing Address - Country:US
Mailing Address - Phone:201-843-6266
Mailing Address - Fax:201-843-1960
Practice Address - Street 1:11 S FARVIEW AVE
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-2607
Practice Address - Country:US
Practice Address - Phone:201-843-6266
Practice Address - Fax:201-843-1960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC01588111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4302728OtherAETNA
NJ1217208Medicaid
NJ0079049000OtherAMERIHEALTH
NJ1497794218OtherINDIVIDUAL NPI
NJP693677OtherOXFORD
NJ1217208Medicaid
NJ1497794218OtherINDIVIDUAL NPI