Provider Demographics
NPI:1831245695
Name:SPEENEY-DORRIAN, JEANMARIE (DC)
Entity type:Individual
Prefix:DR
First Name:JEANMARIE
Middle Name:
Last Name:SPEENEY-DORRIAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:JEANMARIE
Other - Middle Name:
Other - Last Name:SPEENEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:3176 STATE ROUTE 27
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:KENDALL PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08824-1514
Mailing Address - Country:US
Mailing Address - Phone:732-821-6920
Mailing Address - Fax:732-821-2070
Practice Address - Street 1:3176 STATE ROUTE 27
Practice Address - Street 2:SUITE 1C
Practice Address - City:KENDALL PARK
Practice Address - State:NJ
Practice Address - Zip Code:08824-1514
Practice Address - Country:US
Practice Address - Phone:732-821-6920
Practice Address - Fax:732-821-2070
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00417600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8315205Medicaid
NJU65129Medicare UPIN
NJ8315205Medicaid