Provider Demographics
NPI:1437293628
Name:HARTUNG, GARY GEORGE (DC)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:GEORGE
Last Name:HARTUNG
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 1:410 RAMAPO VALLEY RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:OAKLAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07436-2735
Mailing Address - Country:US
Mailing Address - Phone:201-337-3377
Mailing Address - Fax:201-337-3775
Practice Address - Street 1:410 RAMAPO VALLEY RD
Practice Address - Street 2:SUITE 102
Practice Address - City:OAKLAND
Practice Address - State:NJ
Practice Address - Zip Code:07436-2735
Practice Address - Country:US
Practice Address - Phone:201-337-3377
Practice Address - Fax:201-337-3775
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00493500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ643277Medicare ID - Type UnspecifiedMEDICARE