Provider Demographics
NPI:1912229907
Name:ROY, ANDY (DC)
Entity Type:Individual
Prefix:
First Name:ANDY
Middle Name:
Last Name:ROY
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 1:471 CORTLANDT ST.
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109
Mailing Address - Country:US
Mailing Address - Phone:973-759-2222
Mailing Address - Fax:973-759-2226
Practice Address - Street 1:471 CORTLANDT STREET
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109
Practice Address - Country:US
Practice Address - Phone:732-763-5971
Practice Address - Fax:973-759-2226
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-18
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00673600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor