Provider Demographics
NPI:1205801750
Name:MAROULAKOS, HARRY (DC)
Entity type:Individual
Prefix:DR
First Name:HARRY
Middle Name:
Last Name:MAROULAKOS
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 1:1081 PAULISON AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-3627
Mailing Address - Country:US
Mailing Address - Phone:973-253-1155
Mailing Address - Fax:973-253-1165
Practice Address - Street 1:1081 PAULISON AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-3627
Practice Address - Country:US
Practice Address - Phone:973-253-1155
Practice Address - Fax:973-253-1165
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00267800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ450485Medicare ID - Type Unspecified