Provider Demographics
NPI:1447204318
Name:ANGERAMI, GEORGE (DC)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:
Last Name:ANGERAMI
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 1:67 LACEY RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:WHITING
Mailing Address - State:NJ
Mailing Address - Zip Code:08759-2912
Mailing Address - Country:US
Mailing Address - Phone:732-716-1500
Mailing Address - Fax:732-716-1457
Practice Address - Street 1:67 LACEY RD
Practice Address - Street 2:SUITE 4
Practice Address - City:WHITING
Practice Address - State:NJ
Practice Address - Zip Code:08759-2912
Practice Address - Country:US
Practice Address - Phone:732-716-1500
Practice Address - Fax:732-716-1457
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-22
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00517500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8664706Medicaid
NJU87463Medicare UPIN
NJ8664706Medicaid