Provider Demographics
NPI:1659595155
Name:GRAUSO, JOSEPH A (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:A
Last Name:GRAUSO
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 1:214 CHAMBERSBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-2802
Mailing Address - Country:US
Mailing Address - Phone:732-262-5066
Mailing Address - Fax:732-262-5011
Practice Address - Street 1:214 CHAMBERSBRIDGE RD
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-2802
Practice Address - Country:US
Practice Address - Phone:732-262-5066
Practice Address - Fax:732-262-5011
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00390100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ223737754OtherTAX ID NUMBER
NJ223737754OtherTAX ID NUMBER