Provider Demographics
NPI:1710938121
Name:MARSTELLER, MATTHEW JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:JOHN
Last Name:MARSTELLER
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 1:100 KINGS WAY E STE D3
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-2238
Mailing Address - Country:US
Mailing Address - Phone:856-589-0076
Mailing Address - Fax:856-589-3822
Practice Address - Street 1:100 KINGS WAY E STE D3
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-2238
Practice Address - Country:US
Practice Address - Phone:856-589-0076
Practice Address - Fax:856-589-3822
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00647900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0762482Medicaid
1184669954OtherGROUP NPI