Provider Demographics
NPI:1821173220
Name:COLACHE, DANIEL JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JOSEPH
Last Name:COLACHE
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 1:3934 BLACK HORSE PIKE
Mailing Address - Street 2:FESTIVAL AT HAMILTON CENTER
Mailing Address - City:MAYS LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:08330-3107
Mailing Address - Country:US
Mailing Address - Phone:609-625-6399
Mailing Address - Fax:
Practice Address - Street 1:3934 BLACK HORSE PIKE
Practice Address - Street 2:FESTIVAL AT HAMILTON CENTER
Practice Address - City:MAYS LANDING
Practice Address - State:NJ
Practice Address - Zip Code:08330-3107
Practice Address - Country:US
Practice Address - Phone:609-625-6399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC005486111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ9804579OtherCIGNA
NJ2248204OtherUNITED HEALTHCARE
NJ7274195OtherAETNA
NJ21203354713 01OtherBEECHSTREET CORP.
NJNJ05486OtherASHN
NJP2753899OtherOXFORD
NJ2010932000OtherAMERIHEALTH
NJ953158OtherFOCUS
NJ1881760OtherFIRST HEALTH
NJ9149091OtherPHCS
NJ969480OtherONE HEALTH PLAN / GREAT W
NJ1881760OtherFIRST HEALTH
NJ9804579OtherCIGNA