Provider Demographics
NPI:1811098049
Name:ROBERTS, JOY EILEEN (DC)
Entity type:Individual
Prefix:DR
First Name:JOY
Middle Name:EILEEN
Last Name:ROBERTS
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 1:625 CHAMBERS ROCK RD
Mailing Address - Street 2:
Mailing Address - City:LANDENBERG
Mailing Address - State:PA
Mailing Address - Zip Code:19350-1041
Mailing Address - Country:US
Mailing Address - Phone:610-255-5581
Mailing Address - Fax:
Practice Address - Street 1:702 E BASIN RD
Practice Address - Street 2:STE. 2
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-4263
Practice Address - Country:US
Practice Address - Phone:302-322-6676
Practice Address - Fax:302-328-5717
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF10000367111N00000X
PADC005489L111N00000X
NYX007761-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEU57888Medicare UPIN
RO800058Medicare ID - Type Unspecified