Provider Demographics
NPI:1578667150
Name:SIEGEL, CRAIG ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:ALAN
Last Name:SIEGEL
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:PO BOX 338
Mailing Address - Street 2:318 RTE 202-206
Mailing Address - City:PLUCKEMIN
Mailing Address - State:NJ
Mailing Address - Zip Code:07978-0338
Mailing Address - Country:US
Mailing Address - Phone:908-781-9600
Mailing Address - Fax:908-781-7761
Practice Address - Street 1:318 RTE 202-206
Practice Address - Street 2:
Practice Address - City:PLUCKEMIN
Practice Address - State:NJ
Practice Address - Zip Code:07978-0338
Practice Address - Country:US
Practice Address - Phone:908-781-9600
Practice Address - Fax:908-781-7761
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC02593111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ013112Medicare PIN