Provider Demographics
NPI:1013921915
Name:HOLVICK, ANTHONY T (DC)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:T
Last Name:HOLVICK
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 1:506 S NEW YORK RD
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-9761
Mailing Address - Country:US
Mailing Address - Phone:609-748-0222
Mailing Address - Fax:
Practice Address - Street 1:506 S NEW YORK RD
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-9761
Practice Address - Country:US
Practice Address - Phone:609-748-0222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00427300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0004662642OtherAETNA PIN #
NJ42602OtherNYL CARE
NJ505110OtherAMERIHEALTH PPO PIN#
NJ0140371000OtherAMERIHEALTH HOM PIN#
NJU39784Medicare UPIN
NJ505110Medicare PIN