Provider Demographics
NPI:1740402148
Name:PALLUZZI, EDWARD (DC)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:
Last Name:PALLUZZI
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 1:50 THROCKMORTON LN
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-2575
Mailing Address - Country:US
Mailing Address - Phone:732-679-1666
Mailing Address - Fax:732-679-5599
Practice Address - Street 1:50 THROCKMORTON LN
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-2575
Practice Address - Country:US
Practice Address - Phone:732-679-1666
Practice Address - Fax:732-679-5599
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC4587111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ729203Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER