Provider Demographics
NPI:1306854286
Name:SPIEGEL, PATRICIA A (DC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:SPIEGEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:262 SOUTH WHITE HORSE PIKE
Mailing Address - Street 2:BERLIN CHIROPRACTIC
Mailing Address - City:BERLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08009
Mailing Address - Country:US
Mailing Address - Phone:856-768-4366
Mailing Address - Fax:856-768-2023
Practice Address - Street 1:262 SOUTH WHITE HORSE PIKE
Practice Address - Street 2:BERLIN CHIROPRACTIC
Practice Address - City:BERLIN
Practice Address - State:NJ
Practice Address - Zip Code:08009
Practice Address - Country:US
Practice Address - Phone:856-768-4366
Practice Address - Fax:856-768-2023
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ3341111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1781707Medicaid
NJ454305Medicare ID - Type Unspecified