Provider Demographics
NPI:1750374765
Name:GIDDINGS, GEROULD J (DC)
Entity type:Individual
Prefix:DR
First Name:GEROULD
Middle Name:J
Last Name:GIDDINGS
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 1:8511 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:PENNSAUKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08109-3337
Mailing Address - Country:US
Mailing Address - Phone:856-486-7878
Mailing Address - Fax:856-486-7832
Practice Address - Street 1:8511 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:PENNSAUKEN
Practice Address - State:NJ
Practice Address - Zip Code:08109-3337
Practice Address - Country:US
Practice Address - Phone:856-486-7878
Practice Address - Fax:856-486-7832
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00188800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0082657000OtherAMERIHEALTH HMO
PA0082657000OtherAMERIHEALTH HMO
NJ2203299OtherSIGNA
NJP3128809OtherOXFORD
NJ2203299OtherSIGNA
T82402Medicare UPIN