Provider Demographics
NPI:1356327159
Name:PARELLO, EDWARD A (DC)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:A
Last Name:PARELLO
Suffix:
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 1:145 E BAY AVE
Mailing Address - Street 2:
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-3105
Mailing Address - Country:US
Mailing Address - Phone:609-978-0203
Mailing Address - Fax:609-978-8284
Practice Address - Street 1:145 E BAY AVE
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-3105
Practice Address - Country:US
Practice Address - Phone:609-978-0203
Practice Address - Fax:609-978-8284
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-22
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00128800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4559579OtherAETNA INSURANCE
NJ0104882000OtherAMERIHEALTH INSURANCE
NJ454271Medicare PIN
NJT45388Medicare UPIN