Provider Demographics
NPI:1275718363
Name:MARCHEGIANI, EUGENE JR (DC)
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:
Last Name:MARCHEGIANI
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 1:440 KEYSTONE AVE
Mailing Address - Street 2:
Mailing Address - City:PECKVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18452
Mailing Address - Country:US
Mailing Address - Phone:570-489-8669
Mailing Address - Fax:570-489-8669
Practice Address - Street 1:440 KEYSTONE AVE
Practice Address - Street 2:
Practice Address - City:PECKVILLE
Practice Address - State:PA
Practice Address - Zip Code:18452
Practice Address - Country:US
Practice Address - Phone:570-489-8669
Practice Address - Fax:570-489-8669
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002325L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMA192291Medicare PIN