Provider Demographics
NPI:1346387925
Name:WHITE, PAUL J (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:J
Last Name:WHITE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:152 DEER HILL AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-7791
Mailing Address - Country:US
Mailing Address - Phone:203-456-1376
Mailing Address - Fax:203-702-4812
Practice Address - Street 1:152 DEER HILL AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-7791
Practice Address - Country:US
Practice Address - Phone:203-456-1376
Practice Address - Fax:203-702-4812
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2013-07-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT001636111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U82835Medicare UPIN