Provider Demographics
NPI:1821151424
Name:NARDONE CHIROPRACTIC CENTER LLC
Entity Type:Organization
Organization Name:NARDONE CHIROPRACTIC CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:NARDONE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-695-8905
Mailing Address - Street 1:289 LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:FRAZER
Mailing Address - State:PA
Mailing Address - Zip Code:19355-1838
Mailing Address - Country:US
Mailing Address - Phone:610-695-8905
Mailing Address - Fax:610-695-8906
Practice Address - Street 1:289 LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:FRAZER
Practice Address - State:PA
Practice Address - Zip Code:19355-1838
Practice Address - Country:US
Practice Address - Phone:610-695-8905
Practice Address - Fax:610-695-8906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009129111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
085527Medicare PIN
V02391Medicare UPIN