Andrew Edward Herman, DC

Individual provider Active NPI Chiropractor · Gloucester City, NJ

NPI 1609090216 · NPPES record last updated Mar 27, 2012

Key facts

NPI
1609090216
Entity type
Individual (NPI type 1)
Primary specialty
Chiropractor 111N00000X
License
2144 (NJ)
Practice address
357 Greenwood at Market
Gloucester City, NJ 08030
Phone
(856) 742-0584
Fax
(856) 456-1402
NPI assigned
Apr 13, 2007
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NJ

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20090814000307 NJ Practitioner - Chiropractic 6406903277 Practice locations: Gloucester City, NJ

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
2144NJMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Chiropractic Center Chiropractor Past
since Jan 1, 1989
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2144 NJ Yes

Addresses

Primary practice location

357 Greenwood at Market
Gloucester City, NJ 08030

Mailing address

PO Box 559
Gloucester City, NJ 08030
Phone (856) 742-0584

Other identifiers

IdentifierTypeStateIssuer
3042308MedicaidNJ

Other providers in Gloucester City, NJ

All providers in Gloucester City, NJ · Chiropractor in New Jersey

Sources for this page

Verify at the official NPI Registry.