Provider Demographics
NPI:1659450930
Name:CAMMARATA, JOSEPH J (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:J
Last Name:CAMMARATA
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 1:1 BALA PLZ
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1403
Mailing Address - Country:US
Mailing Address - Phone:610-664-5800
Mailing Address - Fax:610-664-6760
Practice Address - Street 1:1 BALA PLZ
Practice Address - Street 2:4TH FLOOR
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1403
Practice Address - Country:US
Practice Address - Phone:610-664-5800
Practice Address - Fax:610-664-6760
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002362L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA196984OtherINDIVIDUAL HIGHMARK PIN
PA0023342000OtherINDIVIDUAL IBC PIN
PA0058127OtherAETNA PPO PIN
PA279521OtherGROUP HIGHMARK PIN
PA5896151OtherAETNA HMO PIN
PA0472793000OtherGROUP IBC PIN
PA0472793000OtherGROUP IBC PIN
PA5896151OtherAETNA HMO PIN
PA196984Medicare ID - Type Unspecified