Provider Demographics
NPI:1609925494
Name:DZIEDZIC, ROSEMARIE KATHERINE (DC)
Entity type:Individual
Prefix:DR
First Name:ROSEMARIE
Middle Name:KATHERINE
Last Name:DZIEDZIC
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:GREGORY
Other - Middle Name:
Other - Last Name:BIGGIANI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:1504 CONCORD CT
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-3771
Mailing Address - Country:US
Mailing Address - Phone:215-529-5416
Mailing Address - Fax:856-728-5444
Practice Address - Street 1:504 SICKLERVILLE RD
Practice Address - Street 2:
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-2626
Practice Address - Country:US
Practice Address - Phone:856-875-1515
Practice Address - Fax:856-728-5444
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00242400111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ22-3023626Medicare UPIN