Provider Demographics
NPI:1437376613
Name:SARACENO, VINCENT (DC)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:
Last Name:SARACENO
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 1:34 CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07102-3704
Mailing Address - Country:US
Mailing Address - Phone:973-242-5828
Mailing Address - Fax:973-242-6691
Practice Address - Street 1:34 CLINTON ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-3704
Practice Address - Country:US
Practice Address - Phone:973-242-5828
Practice Address - Fax:973-242-6691
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00591400111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU99807Medicare UPIN