Provider Demographics
NPI:1952409047
Name:TAGGART, DARLENE M (DC)
Entity Type:Individual
Prefix:DR
First Name:DARLENE
Middle Name:M
Last Name:TAGGART
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 1:94 DIAMOND SPRING ROAD
Mailing Address - Street 2:
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834
Mailing Address - Country:US
Mailing Address - Phone:973-586-1011
Mailing Address - Fax:973-586-6439
Practice Address - Street 1:171 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ROCKAWAY
Practice Address - State:NJ
Practice Address - Zip Code:07866-3319
Practice Address - Country:US
Practice Address - Phone:973-586-1011
Practice Address - Fax:973-586-6439
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC 04875111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0082325Medicaid
NJ005975Medicare ID - Type UnspecifiedPROVIDER #