Active NPI
Douglas Joseph Pucci, DC
- Chiropractor
- Oradell, NJ
National Provider Identifier
1275671018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 38MC00346400
- Practice address
- 617 Oradell Ave
Oradell, NJ 07649-1732 - Phone
- (201) 261-5430
- Fax
- (201) 261-0972
- NPI assigned
- Feb 2, 2007
- Last updated
- Nov 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 38MC00346400 | NJ | Primary |
Addresses
Primary practice location
617 Oradell Ave
Oradell, NJ 07649-1732
Mailing address
617 Oradell Ave
Oradell, NJ 07649-1732
Phone (201) 261-5430
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120220000097 | NJ | Practitioner - Chiropractic | 4486812658 | Practice locations: Oradell, NJ |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38MC00346400 | NJ | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194566400000",
"number": "1275671018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "617 ORADELL AVE",
"city": "ORADELL",
"state": "NJ",
"postal_code": "076491732",
"telephone_number": "201-261-5430",
"fax_number": "201-261-0972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "617 ORADELL AVE",
"city": "ORADELL",
"state": "NJ",
"postal_code": "076491732",
"telephone_number": "201-261-5430",
"fax_number": "201-261-0972"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUCCI",
"first_name": "DOUGLAS",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-02",
"last_updated": "2007-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NJ",
"license": "38MC00346400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oradell, NJ
- Kristin Noel Preziosi
- Andrew M Prince, M.D.
- Proactive Foot and Ankle
- Professional Occupational & Physical Therapy, PLLC
- Professional Orthopedic and Sports Physical Therapy of NJ, LLC
- Quality Medical and Surgical Supplies LLC.
- Regional Womens Health Group,LLC (The Fertility Institute of New Jersey and New York)
- Rehab Consultants LLC
- Reset & Rise Counseling and Therapeutic Services
- Michael Ricciardone Jr., D.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2007; 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.