Provider Demographics
NPI:1720102692
Name:SPIAGGIA, RONALD RAYMOND (DC)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:RAYMOND
Last Name:SPIAGGIA
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 1:459 WATCHUNG AVE
Mailing Address - Street 2:
Mailing Address - City:WATCHUNG
Mailing Address - State:NJ
Mailing Address - Zip Code:07069-4945
Mailing Address - Country:US
Mailing Address - Phone:908-756-2424
Mailing Address - Fax:908-756-2447
Practice Address - Street 1:459 WATCHUNG AVE
Practice Address - Street 2:
Practice Address - City:WATCHUNG
Practice Address - State:NJ
Practice Address - Zip Code:07069-4945
Practice Address - Country:US
Practice Address - Phone:908-756-2424
Practice Address - Fax:908-756-2447
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00586900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ223440358OtherHORIZON BCBS OF NJ
NJ223440358OtherUNITED HEALTHCARE
NJ223440358OtherCIGNA
NJ223440358OtherHEALTHNET
NJP2575701OtherOXFORD
NJ7439496OtherAETNA
NJ916552OtherAMERIHEALTH
NJ413715OtherAETNA HMO
NJU83228Medicare UPIN
NJ223440358OtherHORIZON BCBS OF NJ