Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | MC04476 | NJ |
N | 111NN0400X | Neurology | MC04476 | NJ |
NPI | 1003986654 |
---|---|
Provider Name | Dr. Christopher Marchese |
First Address | Somerville, NJ 08876-2828 |
Second Address | Somerville, NJ 08876-2828 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U52184 | (02) | NJ |