Provider Demographics
NPI:1942306642
Name:DUNLAP-BEALES, MARY (DC)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:
Last Name:DUNLAP-BEALES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MISS
Other - First Name:MARY
Other - Middle Name:
Other - Last Name:DUNLAP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:10 W 46TH ST
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-4003
Mailing Address - Country:US
Mailing Address - Phone:201-339-8803
Mailing Address - Fax:201-339-1101
Practice Address - Street 1:864 BROADWAY
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-3054
Practice Address - Country:US
Practice Address - Phone:201-339-8803
Practice Address - Fax:201-339-1101
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC0003536111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor