Provider Demographics
NPI:1629165782
Name:FIRST CHOICE HEALTH GROUPLLC
Entity Type:Organization
Organization Name:FIRST CHOICE HEALTH GROUPLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:CRUOGLIO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-920-5646
Mailing Address - Street 1:781 BRICK BLVD
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-4160
Mailing Address - Country:US
Mailing Address - Phone:732-920-5646
Mailing Address - Fax:732-920-6000
Practice Address - Street 1:781 BRICK BLVD
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-4160
Practice Address - Country:US
Practice Address - Phone:732-920-5646
Practice Address - Fax:732-920-6000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MCOO208900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty