Provider Demographics
NPI:1194829507
Name:CARLUCCI, JOHN FRANCIS (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:FRANCIS
Last Name:CARLUCCI
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 1:2105 W COUNTY LINE RD
Mailing Address - Street 2:SUITE #7
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527
Mailing Address - Country:US
Mailing Address - Phone:732-370-5800
Mailing Address - Fax:732-370-6772
Practice Address - Street 1:2105 W COUNTY LINE RD
Practice Address - Street 2:SUITE # 7
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-2301
Practice Address - Country:US
Practice Address - Phone:732-370-5800
Practice Address - Fax:732-370-6772
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00350200111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJT88762Medicare UPIN