Provider Demographics
NPI:1922184399
Name:DUNLOP, RUSSELL JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:JAMES
Last Name:DUNLOP
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 1:146 W END AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-1816
Mailing Address - Country:US
Mailing Address - Phone:908-526-2883
Mailing Address - Fax:908-526-2885
Practice Address - Street 1:146 W END AVE
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-1816
Practice Address - Country:US
Practice Address - Phone:908-526-2883
Practice Address - Fax:908-526-2885
Is Sole Proprietor?:No
Enumeration Date:2006-10-28
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00150700111N00000X
NJ25MZ00025500171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ222316464OtherTAX ID NUMBER
NJ222316464OtherTAX ID NUMBER
NJT44778Medicare UPIN