Provider Demographics
NPI:1346350121
Name:SORIERO FAMILY CHIROPRACTIC PA
Entity Type:Organization
Organization Name:SORIERO FAMILY CHIROPRACTIC PA
Other - Org Name:ANTHONY C SORIERO D.C. P.A.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:IVY
Authorized Official - Middle Name:S
Authorized Official - Last Name:TOBIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-586-9199
Mailing Address - Street 1:3679 A NOTTINGHAM WAY
Mailing Address - Street 2:
Mailing Address - City:HAMILTON SQUARE
Mailing Address - State:NJ
Mailing Address - Zip Code:58690
Mailing Address - Country:US
Mailing Address - Phone:609-586-9199
Mailing Address - Fax:609-586-5766
Practice Address - Street 1:3679 A NOTTINGHAM WAY
Practice Address - Street 2:
Practice Address - City:HAMILTON SQUARE
Practice Address - State:NJ
Practice Address - Zip Code:58690
Practice Address - Country:US
Practice Address - Phone:609-586-9199
Practice Address - Fax:609-586-5766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00138200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ076157Medicare PIN