Provider Demographics
NPI:1922081660
Name:PICARELLI, JOSAFIN (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSAFIN
Middle Name:
Last Name:PICARELLI
Suffix:
Gender:F
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:PO BOX 526
Mailing Address - Street 2:
Mailing Address - City:WEST PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07424-0526
Mailing Address - Country:US
Mailing Address - Phone:973-890-0011
Mailing Address - Fax:973-890-7505
Practice Address - Street 1:1046 MCBRIDE AVE
Practice Address - Street 2:
Practice Address - City:WOODLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07424-2508
Practice Address - Country:US
Practice Address - Phone:973-890-0011
Practice Address - Fax:972-890-7505
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMCO3420111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ477135Medicare ID - Type UnspecifiedMEDICARE NUMBER
NJT87622Medicare UPIN