Provider Demographics
NPI:1477606747
Name:PATRAS, ANTHONY (DC CHIROPRACTOR)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:PATRAS
Suffix:
Gender:M
Credentials:DC CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:434 RAHWAY AVENUE
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07095
Mailing Address - Country:US
Mailing Address - Phone:732-855-7500
Mailing Address - Fax:732-634-7923
Practice Address - Street 1:434 RAHWAY AVENUE
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07095
Practice Address - Country:US
Practice Address - Phone:732-855-7500
Practice Address - Fax:732-634-7923
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1618111N00000X
FLCH0002617111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ460222Medicare ID - Type Unspecified