Provider Demographics
NPI:1740291012
Name:LOCKHART, ANGELA (DC)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:
Last Name:LOCKHART
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 NEW RD
Mailing Address - Street 2:UNIT C3
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-4274
Mailing Address - Country:US
Mailing Address - Phone:973-808-6262
Mailing Address - Fax:973-808-1468
Practice Address - Street 1:239 NEW RD
Practice Address - Street 2:UNIT C3
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-4274
Practice Address - Country:US
Practice Address - Phone:973-808-6262
Practice Address - Fax:973-808-1468
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00316400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ451073Medicare ID - Type Unspecified