Provider Demographics
NPI:1144215450
Name:GASPAROVIC, FRANK RICHARD JR (DC)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:RICHARD
Last Name:GASPAROVIC
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5581
Mailing Address - Street 2:
Mailing Address - City:DEPTFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-0581
Mailing Address - Country:US
Mailing Address - Phone:856-582-5860
Mailing Address - Fax:856-582-5431
Practice Address - Street 1:284 DELSEA DR
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-9469
Practice Address - Country:US
Practice Address - Phone:856-582-5860
Practice Address - Fax:856-582-5431
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ04447111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJGA666934Medicare ID - Type Unspecified