Provider Demographics
NPI:1023140209
Name:ERCEG, PATRICIA ANN (CHIROPRACTOR)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:ERCEG
Suffix:
Gender:F
Credentials:CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 640
Mailing Address - Street 2:1108 OLD YORK ROAD
Mailing Address - City:RINGOES
Mailing Address - State:NJ
Mailing Address - Zip Code:08551
Mailing Address - Country:US
Mailing Address - Phone:908-237-0012
Mailing Address - Fax:908-237-9954
Practice Address - Street 1:1108 OLD YORK ROAD
Practice Address - Street 2:
Practice Address - City:RINGOES
Practice Address - State:NJ
Practice Address - Zip Code:08551
Practice Address - Country:US
Practice Address - Phone:908-237-0012
Practice Address - Fax:908-237-9954
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38ML00261200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ458225Medicare ID - Type Unspecified