Mark Pandolfo, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

38MC00530300 Issued in NJ

Legal business name

MARK PANDOLFO, DC

Practice address

175 W Cohawkin Rd
Clarksboro, NJ 08020-1145

Phone

(856) 423-5559

NPI assigned

Feb 21, 2006

Last updated

Apr 8, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark P Pandolfo, DCNPI 1225003536

Title

Owner

Phone

(856) 423-5559

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark P Pandolfo, DC

  • Chiropractor
  • Clarksboro, NJ
  • NPI 1225003536
  NPD (past) Authorized official

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207612800000",
    "number": "1710952023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 W COHAWKIN RD",
            "city": "CLARKSBORO",
            "state": "NJ",
            "postal_code": "080201145",
            "telephone_number": "856-423-5559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 W COHAWKIN RD",
            "city": "CLARKSBORO",
            "state": "NJ",
            "postal_code": "080201145",
            "telephone_number": "856-423-5559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK PANDOLFO, DC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-21",
        "last_updated": "2008-04-08",
        "status": "A",
        "authorized_official_last_name": "PANDOLFO",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-423-5559",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00530300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.