Theodore B. Siciliano,DC LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

38MC00170300 Issued in NJ

Legal business name

THEODORE B. SICILIANO,DC LLC

Practice address

720 S Main St
West Creek, NJ 08092-3121

Phone

(609) 597-9333

NPI assigned

Feb 22, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Theodore B. Siciliano, DCNPI 1912055500

Title

President

Phone

(609) 597-9333

Specialties & licenses 1

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.

• Theodore B Siciliano, DC

  • Chiropractor
  • West Creek, NJ
  • NPI 1912055500
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1298332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298332800000",
    "number": "1124325428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 S MAIN ST",
            "city": "WEST CREEK",
            "state": "NJ",
            "postal_code": "080923121",
            "telephone_number": "609-597-9333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 S MAIN ST",
            "city": "WEST CREEK",
            "state": "NJ",
            "postal_code": "080923121",
            "telephone_number": "609-597-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEODORE B. SICILIANO,DC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-22",
        "last_updated": "2011-02-22",
        "status": "A",
        "authorized_official_last_name": "SICILIANO",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "609-597-9333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00170300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marguerite Schwartz
• Serene Therapy
• Theodore B Siciliano, DC
• Speech Pathology Solutions, LLC
• Julia Anne Terrezza
• Rebecca C Van Ness
• Richard Weber, D.C.
• West Creek Dental, LLC
• Lisa Ann Willoughby, MS,CCC/SLP

• Chiropractor in West Creek, NJ
• Providers in West Creek, 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 22, 2011; 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.