Provider Demographics
NPI:1154487023
Name:RECCE, ANTHONY J JR (DC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:J
Last Name:RECCE
Suffix:JR
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 1:806 LANDMARK DR STE 126
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-4966
Mailing Address - Country:US
Mailing Address - Phone:410-766-0333
Mailing Address - Fax:410-766-9289
Practice Address - Street 1:7231 B RITCHIE HIGHWAY
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21060
Practice Address - Country:US
Practice Address - Phone:410-766-0333
Practice Address - Fax:410-766-9289
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01804 PT111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
2670535OtherAETNA
7458054OtherAETNA
2135545OtherOPTIMUM CHOICE
2135545OtherMDIPA
2135545OtherMAMSI
7458054OtherAETNA
083EMedicare ID - Type UnspecifiedRENDERING
2135545OtherMAMSI