Provider Demographics
NPI:1952406696
Name:MARSHALL, JAMES A (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:A
Last Name:MARSHALL
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 1:1195 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-2252
Mailing Address - Country:US
Mailing Address - Phone:973-772-7676
Mailing Address - Fax:973-772-7025
Practice Address - Street 1:1195 MAIN AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-2242
Practice Address - Country:US
Practice Address - Phone:973-772-7676
Practice Address - Fax:973-772-7025
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ30MC00508700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0075531Medicaid
NJU94300Medicare UPIN
NJ0075531Medicaid