Provider Demographics
NPI:1932227204
Name:ANZALONE, JOSEPH C (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:C
Last Name:ANZALONE
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 1:438 SPRINGDALE AVE
Mailing Address - Street 2:
Mailing Address - City:HATBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19040-2245
Mailing Address - Country:US
Mailing Address - Phone:215-942-2111
Mailing Address - Fax:215-328-0894
Practice Address - Street 1:1810 COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-1720
Practice Address - Country:US
Practice Address - Phone:215-942-2111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002294L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0023314000OtherBLUE CROSS PROVIDER
PA0023314000OtherBLUE CROSS PROVIDER