Provider Demographics
NPI:1871788497
Name:METZGER, PERRY MARC (DOCTOR OF CHIROPRACT)
Entity type:Individual
Prefix:DR
First Name:PERRY
Middle Name:MARC
Last Name:METZGER
Suffix:
Gender:M
Credentials:DOCTOR OF CHIROPRACT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:359 NORTH BEVERWYCK RD
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-1539
Mailing Address - Country:US
Mailing Address - Phone:973-334-6868
Mailing Address - Fax:973-263-8892
Practice Address - Street 1:359 NORTH BEVERWYCK RD
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-1539
Practice Address - Country:US
Practice Address - Phone:973-334-6868
Practice Address - Fax:973-263-8892
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00650200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU02591Medicare UPIN
FL22555AMedicare PIN