Provider Demographics
NPI:1871615278
Name:PAUL, JOSEPH MARC (DC)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MARC
Last Name:PAUL
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 1:1 AIRPORT PL STE 4
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-1532
Mailing Address - Country:US
Mailing Address - Phone:609-924-5678
Mailing Address - Fax:609-924-5652
Practice Address - Street 1:1 AIRPORT PL STE 4
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-1532
Practice Address - Country:US
Practice Address - Phone:609-924-5678
Practice Address - Fax:609-924-5652
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC004998111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ815934RRJMedicare ID - Type Unspecified