Provider Demographics
NPI:1497787451
Name:GELLASCH, ERIC ALLEN (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:ALLEN
Last Name:GELLASCH
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 1:2791 NOTTINGHAM WAY
Mailing Address - Street 2:
Mailing Address - City:MERCERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-1854
Mailing Address - Country:US
Mailing Address - Phone:609-631-2945
Mailing Address - Fax:609-631-0052
Practice Address - Street 1:2791 NOTTINGHAM WAY
Practice Address - Street 2:
Practice Address - City:MERCERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08619-1854
Practice Address - Country:US
Practice Address - Phone:609-631-2945
Practice Address - Fax:609-631-0052
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC-04948111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ000374059OtherIND. BC/BS PPO, AMERIHEAL
NJ22-3566536OtherHORIZON BC/BS OF NJ
NJ2054312OtherUNITED HEALTHCARE
NJ0091180000OtherAMERIHEALTH/KEYSTONE/IND.
NJ2014119OtherAETNA
NJP1063574OtherOXFORD
NJP1063574OtherOXFORD
NJ22-3566536OtherHORIZON BC/BS OF NJ