Provider Demographics
NPI:1437238615
Name:CECCHINI, JOHN ANTHONY SR (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ANTHONY
Last Name:CECCHINI
Suffix:SR
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 1:100 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:NJ
Mailing Address - Zip Code:08065-1629
Mailing Address - Country:US
Mailing Address - Phone:856-786-0070
Mailing Address - Fax:856-786-7678
Practice Address - Street 1:100 E BROAD ST
Practice Address - Street 2:
Practice Address - City:PALMYRA
Practice Address - State:NJ
Practice Address - Zip Code:08065-1629
Practice Address - Country:US
Practice Address - Phone:856-786-0070
Practice Address - Fax:856-786-7678
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC3093111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP543126OtherOXFORD
NJ00976652-001OtherUNITED HEALTH CARE
NJ0418797000OtherAMERIHEALTH
NJ5193852003OtherCIGNA
NJU24668Medicare UPIN
NJ579954PVCMedicare ID - Type UnspecifiedMEDICARE