Provider Demographics
NPI:1255404174
Name:CARONE, NICHOLAS VITO (DC)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:VITO
Last Name:CARONE
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 1:1300 HORIZON DRIVE
Mailing Address - Street 2:SUITE 111
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914
Mailing Address - Country:US
Mailing Address - Phone:215-822-0071
Mailing Address - Fax:215-822-1021
Practice Address - Street 1:1300 HORIZON DRIVE
Practice Address - Street 2:SUITE 111
Practice Address - City:CHALFONT
Practice Address - State:PA
Practice Address - Zip Code:18914
Practice Address - Country:US
Practice Address - Phone:215-822-0071
Practice Address - Fax:215-822-1021
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007786L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001612926OtherBLUE CROSS BLUE SHIELD
PA0876977000OtherINDEPENDENCE BLUE CROSS
PA001612926OtherBLUE CROSS BLUE SHIELD
CA088868Medicare ID - Type Unspecified
088868Medicare PIN