Provider Demographics
NPI:1639803331
Name:GULOTTA CHIROPRACTIC
Entity Type:Organization
Organization Name:GULOTTA CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:GULOTTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-681-2200
Mailing Address - Street 1:1717 MAIN ST UNIT 101
Mailing Address - Street 2:
Mailing Address - City:LAKE COMO
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-3096
Mailing Address - Country:US
Mailing Address - Phone:732-681-2200
Mailing Address - Fax:732-681-5954
Practice Address - Street 1:1717 MAIN ST UNIT 101
Practice Address - Street 2:
Practice Address - City:LAKE COMO
Practice Address - State:NJ
Practice Address - Zip Code:07719-3096
Practice Address - Country:US
Practice Address - Phone:732-681-2200
Practice Address - Fax:732-681-5954
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GULOTTA CHIROPRACTIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-07-11
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty