Provider Demographics
NPI:1275639619
Name:CALDWELL, FRANK MATTHEW (DC)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:MATTHEW
Last Name:CALDWELL
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 1:20 N 20TH ST
Mailing Address - Street 2:
Mailing Address - City:KENILWORTH
Mailing Address - State:NJ
Mailing Address - Zip Code:07033-1677
Mailing Address - Country:US
Mailing Address - Phone:908-276-4255
Mailing Address - Fax:908-276-4255
Practice Address - Street 1:20 N 20TH ST
Practice Address - Street 2:
Practice Address - City:KENILWORTH
Practice Address - State:NJ
Practice Address - Zip Code:07033-1677
Practice Address - Country:US
Practice Address - Phone:908-276-4255
Practice Address - Fax:908-276-4255
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC004335111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
543116Medicare ID - Type Unspecified