Provider Demographics
NPI:1649505959
Name:MERRITT, SONNY BARTH (DC)
Entity type:Individual
Prefix:MR
First Name:SONNY
Middle Name:BARTH
Last Name:MERRITT
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 1:484 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07506-2522
Mailing Address - Country:US
Mailing Address - Phone:973-423-4770
Mailing Address - Fax:
Practice Address - Street 1:484 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:NJ
Practice Address - Zip Code:07506-2522
Practice Address - Country:US
Practice Address - Phone:973-423-4770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00485900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor