Provider Demographics
NPI:1518082676
Name:YEPEZ-ZIEGENBALG, EMMA LUCIA (DC)
Entity Type:Individual
Prefix:DR
First Name:EMMA
Middle Name:LUCIA
Last Name:YEPEZ-ZIEGENBALG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 JEFFERY RD
Mailing Address - Street 2:
Mailing Address - City:COLONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07067-2413
Mailing Address - Country:US
Mailing Address - Phone:732-499-9191
Mailing Address - Fax:732-499-8618
Practice Address - Street 1:622 INMAN AVE
Practice Address - Street 2:
Practice Address - City:COLONIA
Practice Address - State:NJ
Practice Address - Zip Code:07067-1000
Practice Address - Country:US
Practice Address - Phone:732-499-9191
Practice Address - Fax:732-499-8618
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2009-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC04763111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
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NJ2087552OtherAETNA HMO
NJ2029096OtherUNITED HEALTHCARE
NJ31188OtherMASTER CARE BEECH STREET
NJ5716539OtherGHI
NJU75450OtherHEALTHNET
NJ66895OtherOPERATING ENGINEERS LOCAL
NJIK9553OtherLANDMARK
NJ350051564OtherRAILROAD MEDICARE
NJX4D801OtherWELLCHOICE
NJ5138468OtherAETNA PPO
NJX4D801OtherWELLCHOICE