Provider Demographics
NPI:1306054788
Name:GAROLIS, JOSEPH JOHN JR (DC)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:JOHN
Last Name:GAROLIS
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 1:19 POINT VIEW PKWY
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2055
Mailing Address - Country:US
Mailing Address - Phone:201-315-1141
Mailing Address - Fax:
Practice Address - Street 1:19 POINT VIEW PKWY
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2055
Practice Address - Country:US
Practice Address - Phone:201-869-6446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009706-1111N00000X
NJ38MC00188700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2K9294OtherHEALTH NET
NJP652573OtherOXFORD
NJP652573OtherOXFORD