Provider Demographics
NPI:1619166352
Name:MONROE CHIROPRACTIC PC
Entity Type:Organization
Organization Name:MONROE CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMARCO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-521-1333
Mailing Address - Street 1:15 E RAILROAD AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:JAMESBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-1465
Mailing Address - Country:US
Mailing Address - Phone:732-521-1333
Mailing Address - Fax:732-521-1687
Practice Address - Street 1:15 E RAILROAD AVE
Practice Address - Street 2:SUITE C
Practice Address - City:JAMESBURG
Practice Address - State:NJ
Practice Address - Zip Code:08831-1465
Practice Address - Country:US
Practice Address - Phone:732-521-1333
Practice Address - Fax:732-521-1687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ520261Medicare PIN