Provider Demographics
NPI:1871705285
Name:WINN, JOHN (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:WINN
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 1:10 WOODCLIFF LAKE RD
Mailing Address - Street 2:
Mailing Address - City:SADDLE RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07458-3006
Mailing Address - Country:US
Mailing Address - Phone:201-825-7808
Mailing Address - Fax:201-327-6907
Practice Address - Street 1:10 WOODCLIFF LAKE RD
Practice Address - Street 2:
Practice Address - City:SADDLE RIVER
Practice Address - State:NJ
Practice Address - Zip Code:07458-3006
Practice Address - Country:US
Practice Address - Phone:201-825-7808
Practice Address - Fax:201-327-6907
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-06
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00139600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ35216389CMedicaid
NJ0102211000OtherAMERIHEALTH ID NUMBER
NJBC00975OtherBLUE CROSS BLUE SHIELD ID
NJ0102211000OtherAMERIHEALTH ID NUMBER
NJ35216389CMedicaid
NJT82425Medicare UPIN