Provider Demographics
NPI:1497987770
Name:MARELLI, MARIO JOSEPH (DC)
Entity Type:Individual
Prefix:
First Name:MARIO
Middle Name:JOSEPH
Last Name:MARELLI
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 1:108 BEATTYS RD
Mailing Address - Street 2:
Mailing Address - City:STEWARTSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08886-2201
Mailing Address - Country:US
Mailing Address - Phone:973-703-1356
Mailing Address - Fax:
Practice Address - Street 1:404 ROUTE 57
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-9407
Practice Address - Country:US
Practice Address - Phone:973-703-1356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-20
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00197800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor