Kimberly G Maziarz-Carlucci DC LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

MC04955 Issued in NJ

Legal business name

KIMBERLY G MAZIARZ-CARLUCCI DC LLC

Practice address

86 Valley Rd
Montclair, NJ 07042-2209

Phone

(973) 744-9880

Fax

(973) 744-9883

NPI assigned

Mar 1, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kimberly G Carlucci, DCNPI 1346387438

Title

Owner

Phone

(973) 744-9880

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kimberly G Carlucci, D.C.

  • Chiropractor
  • Montclair, NJ
  • NPI 1346387438
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518739200000",
    "number": "1124156005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 VALLEY RD",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422209",
            "telephone_number": "973-744-9880",
            "fax_number": "973-744-9883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 VALLEY RD",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422209",
            "telephone_number": "973-744-9880",
            "fax_number": "973-744-9883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLY G MAZIARZ-CARLUCCI DC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2018-02-16",
        "status": "A",
        "authorized_official_last_name": "CARLUCCI",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-744-9880",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "MC04955",
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Montclair, NJ
• Providers in Montclair, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.