Provider Demographics
NPI:1972729309
Name:HORAN, RAY (DC)
Entity Type:Individual
Prefix:
First Name:RAY
Middle Name:
Last Name:HORAN
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 1:261 STATE ROUTE 35
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-5911
Mailing Address - Country:US
Mailing Address - Phone:732-842-5566
Mailing Address - Fax:732-842-3363
Practice Address - Street 1:261 STATE ROUTE 35
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-5911
Practice Address - Country:US
Practice Address - Phone:732-842-5566
Practice Address - Fax:732-842-3363
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC002553111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ450022Medicare ID - Type UnspecifiedPROVIDER