Provider Demographics
NPI:1447425228
Name:FORZANI FAMILY CHIROPRACTIC II INC
Entity Type:Organization
Organization Name:FORZANI FAMILY CHIROPRACTIC II INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:A
Authorized Official - Last Name:FORZANI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-974-9100
Mailing Address - Street 1:1930 HIGHWAY 35
Mailing Address - Street 2:SUITE 5 1ST FLOOR ALLAIRE PLAZA
Mailing Address - City:WALL
Mailing Address - State:NJ
Mailing Address - Zip Code:07719
Mailing Address - Country:US
Mailing Address - Phone:732-974-9100
Mailing Address - Fax:732-974-7964
Practice Address - Street 1:1930 HIGHWAY 35
Practice Address - Street 2:SUITE 5 1ST FLOOR ALLAIRE PLAZA
Practice Address - City:WALL
Practice Address - State:NJ
Practice Address - Zip Code:07719
Practice Address - Country:US
Practice Address - Phone:732-974-9100
Practice Address - Fax:732-974-7964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-23
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJLC4255111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1447425228OtherMEDICARE
NJ1447425228OtherMEDICARE