Provider Demographics
NPI:1720165335
Name:NARCISO, ANTHONY (DC)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:NARCISO
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 1:510 43RD ST
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-2612
Mailing Address - Country:US
Mailing Address - Phone:201-866-2130
Mailing Address - Fax:
Practice Address - Street 1:510 43RD ST
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-2612
Practice Address - Country:US
Practice Address - Phone:201-866-2130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC005299111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8345503Medicaid
NJMC005299Medicare UPIN
NJ8345503Medicaid