Provider Demographics
NPI:1164795597
Name:BARTUCCI FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:BARTUCCI FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:609-597-5500
Mailing Address - Street 1:133 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-2933
Mailing Address - Country:US
Mailing Address - Phone:609-597-5500
Mailing Address - Fax:609-597-5566
Practice Address - Street 1:133 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-2933
Practice Address - Country:US
Practice Address - Phone:609-597-5500
Practice Address - Fax:609-597-5566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-15
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00549600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU89448Medicare UPIN
NJ235777Medicare PIN