Provider Demographics
NPI:1801003942
Name:SHARI SALUCK, D.C., L.L.C.
Entity Type:Organization
Organization Name:SHARI SALUCK, D.C., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LA SHEMA
Authorized Official - Middle Name:
Authorized Official - Last Name:GAINEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-354-5090
Mailing Address - Street 1:212 N HADDON AVE
Mailing Address - Street 2:
Mailing Address - City:HADDONFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08033-2323
Mailing Address - Country:US
Mailing Address - Phone:856-354-5090
Mailing Address - Fax:856-354-5009
Practice Address - Street 1:212 HADDON AVENUE
Practice Address - Street 2:
Practice Address - City:HADDONFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08033
Practice Address - Country:US
Practice Address - Phone:856-354-5090
Practice Address - Fax:856-354-5009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2016-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC004990111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U33735Medicare UPIN
050659Medicare ID - Type Unspecified