Provider Demographics
NPI:1134269608
Name:COLAIZZO, CATHERINE (DC)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:COLAIZZO
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 1:1075 EASTON AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-1648
Mailing Address - Country:US
Mailing Address - Phone:732-545-5999
Mailing Address - Fax:732-545-3439
Practice Address - Street 1:1075 EASTON AVE
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-1648
Practice Address - Country:US
Practice Address - Phone:732-545-5999
Practice Address - Fax:732-545-3439
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00343900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ592406Medicare ID - Type UnspecifiedMEDICARE PROVIDER #
NJT91019Medicare UPIN