Provider Demographics
NPI:1619977725
Name:HUTCHISON-DANILUK, VALERIE J (DC)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:J
Last Name:HUTCHISON-DANILUK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:JH
Other - Last Name:DANILUK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:503 BRICK BLVD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-6097
Mailing Address - Country:US
Mailing Address - Phone:732-920-2729
Mailing Address - Fax:732-262-8071
Practice Address - Street 1:503 BRICK BLVD
Practice Address - Street 2:SUITE 107
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-6097
Practice Address - Country:US
Practice Address - Phone:732-920-2729
Practice Address - Fax:732-262-8071
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-29
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00563100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ051686Medicare ID - Type Unspecified