Provider Demographics
NPI:1891998266
Name:NEW TRIPOLI WHOLE HEALTH P.C.
Entity Type:Organization
Organization Name:NEW TRIPOLI WHOLE HEALTH P.C.
Other - Org Name:NEW TRIPOLI CHIROPRACTIC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:MARZANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-298-8029
Mailing Address - Street 1:6505 ROUTE 309
Mailing Address - Street 2:
Mailing Address - City:NEW TRIPOLI
Mailing Address - State:PA
Mailing Address - Zip Code:18066-3822
Mailing Address - Country:US
Mailing Address - Phone:610-298-8029
Mailing Address - Fax:610-298-8029
Practice Address - Street 1:6505 ROUTE 309
Practice Address - Street 2:
Practice Address - City:NEW TRIPOLI
Practice Address - State:PA
Practice Address - Zip Code:18066-3822
Practice Address - Country:US
Practice Address - Phone:610-298-8029
Practice Address - Fax:610-298-8029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009711111N00000X
261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1891998266Medicaid