Provider Demographics
NPI:1952428252
Name:BIDWELL, SYLVIA A (DC)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:A
Last Name:BIDWELL
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 1:212 W ROUTE 38
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-3238
Mailing Address - Country:US
Mailing Address - Phone:856-273-1551
Mailing Address - Fax:856-273-9988
Practice Address - Street 1:212 W ROUTE 38
Practice Address - Street 2:SUITE 100
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-3238
Practice Address - Country:US
Practice Address - Phone:856-273-1551
Practice Address - Fax:856-273-9988
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC04747111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U70578Medicare UPIN