Provider Demographics
NPI:1679757009
Name:CURTIS, DEAN L (DC)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:L
Last Name:CURTIS
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 1:588 ROUTE 10 WEST
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869
Mailing Address - Country:US
Mailing Address - Phone:973-366-6615
Mailing Address - Fax:973-366-9427
Practice Address - Street 1:588 ROUTE 10 WEST
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869
Practice Address - Country:US
Practice Address - Phone:973-366-6615
Practice Address - Fax:973-366-9427
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-20
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMCO3510111N00000X
NYX009592-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ536507Medicare PIN