Provider Demographics
NPI:1689997470
Name:BLINCHIK MAUGERI, ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:
Last Name:BLINCHIK MAUGERI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 MAJESTIC DR
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-1449
Mailing Address - Country:US
Mailing Address - Phone:732-580-5397
Mailing Address - Fax:732-252-8729
Practice Address - Street 1:36 MAJESTIC DR
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-1449
Practice Address - Country:US
Practice Address - Phone:732-580-5397
Practice Address - Fax:732-252-8729
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-08
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00454500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor