Provider Demographics
NPI:1447201785
Name:O'ROURKE, JOSEPH P (DC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:P
Last Name:O'ROURKE
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 1:29 FALKINBURG DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE EGG HARBOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08087-3625
Mailing Address - Country:US
Mailing Address - Phone:609-296-1116
Mailing Address - Fax:
Practice Address - Street 1:29 FALKINBURG DR
Practice Address - Street 2:
Practice Address - City:LITTLE EGG HARBOR
Practice Address - State:NJ
Practice Address - Zip Code:08087-3625
Practice Address - Country:US
Practice Address - Phone:609-296-1116
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00604700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ092393Medicare ID - Type Unspecified
NJV05601Medicare UPIN