Provider Demographics
NPI:1164506325
Name:MAUTE, JOHN E (DC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:E
Last Name:MAUTE
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 1:694 ROUTE 15 SOUTH
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LAKE HOPATCONG
Mailing Address - State:NJ
Mailing Address - Zip Code:07849
Mailing Address - Country:US
Mailing Address - Phone:973-663-3733
Mailing Address - Fax:973-663-0130
Practice Address - Street 1:694 ROUTE 15 SOUTH
Practice Address - Street 2:SUITE 102
Practice Address - City:LAKE HOPATCONG
Practice Address - State:NJ
Practice Address - Zip Code:07849
Practice Address - Country:US
Practice Address - Phone:973-663-3733
Practice Address - Fax:973-663-0130
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC05039111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ005622Medicare ID - Type Unspecified