Provider Demographics
NPI:1295235091
Name:SHORE CHIROPRACTIC AND ACUPUNCTURE, LLC
Entity type:Organization
Organization Name:SHORE CHIROPRACTIC AND ACUPUNCTURE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:R
Authorized Official - Last Name:SCAPICIO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-842-4412
Mailing Address - Street 1:180 WHITE RD STE 205
Mailing Address - Street 2:
Mailing Address - City:LITTLE SILVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07739-1166
Mailing Address - Country:US
Mailing Address - Phone:732-842-4412
Mailing Address - Fax:
Practice Address - Street 1:180 WHITE RD STE 205
Practice Address - Street 2:
Practice Address - City:LITTLE SILVER
Practice Address - State:NJ
Practice Address - Zip Code:07739-1166
Practice Address - Country:US
Practice Address - Phone:732-842-4412
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-19
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00064800171100000X
NJ38MC00258800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty