Provider Demographics
NPI:1376255703
Name:CHIANESE, CHRIS (MS, DC)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:
Last Name:CHIANESE
Suffix:
Gender:M
Credentials:MS, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 562
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-0562
Mailing Address - Country:US
Mailing Address - Phone:609-651-7436
Mailing Address - Fax:
Practice Address - Street 1:5 W CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:MERCHANTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08109-2309
Practice Address - Country:US
Practice Address - Phone:609-577-4861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-16
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011580111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor