Provider Demographics
NPI:1477572659
Name:INSANA, DEAN (DC)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:
Last Name:INSANA
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 1:2028 CHAPEL AVE W
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-2014
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2028 CHAPEL AVE W
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-2014
Practice Address - Country:US
Practice Address - Phone:856-662-4848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2022-08-03
Deactivation Date:2022-06-13
Deactivation Code:
Reactivation Date:2022-08-03
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00493400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
884960Medicare ID - Type Unspecified