Louis Edward Persichetti, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

38MC00269100 Issued in NJ

Practice address

106 Centre Blvd Ste B
Marlton, NJ 08053-4131

Phone

(856) 596-8484

Fax

(856) 596-7146

NPI assigned

Sep 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289174400000",
    "number": "1912005539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 CENTRE BLVD STE B",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534131",
            "telephone_number": "856-596-8484",
            "fax_number": "856-596-7146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 CENTRE BLVD STE B",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534131",
            "telephone_number": "856-596-8484",
            "fax_number": "856-596-7146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSICHETTI",
        "first_name": "LOUIS",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2010-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00269100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6284906",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2010; 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.