Provider Demographics
NPI:1942373436
Name:PERRONE, ANDREW S (DC)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:S
Last Name:PERRONE
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 1:6 SPRING VALLEY AVE
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-3801
Mailing Address - Country:US
Mailing Address - Phone:201-489-9555
Mailing Address - Fax:201-489-9569
Practice Address - Street 1:6 SPRING VALLEY AVE
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-3801
Practice Address - Country:US
Practice Address - Phone:201-489-9555
Practice Address - Fax:201-489-9569
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00541200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU75828Medicare UPIN