Provider Demographics
NPI:1659305290
Name:MARSTON, PAUL FRANCIS (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:FRANCIS
Last Name:MARSTON
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 1:300 KAKEOUT RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:KINNELON
Mailing Address - State:NJ
Mailing Address - Zip Code:07405
Mailing Address - Country:US
Mailing Address - Phone:973-838-6252
Mailing Address - Fax:973-838-4159
Practice Address - Street 1:300 KAKEOUT RD
Practice Address - Street 2:SUITE B
Practice Address - City:KINNELON
Practice Address - State:NJ
Practice Address - Zip Code:07405-2548
Practice Address - Country:US
Practice Address - Phone:973-838-6252
Practice Address - Fax:973-838-4159
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC3989111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ124639Medicare UPIN