MEDICARE: UNION CHIROPRACTIC CENTER PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	40QA01162800	NJ
2	111N00000X	Chiropractor	38MC00603500	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2K5605	OTHER	NJ	HEALTHNET
2	3325455	OTHER	NJ	AETNA HMO
3	9284171003	OTHER	NJ	CONNECTICUT GENERAL INS
4	1523495	OTHER	NJ	AMERICHOICE
5	P2752095	OTHER	NJ	OXFORD

General Provider Information

NPI Number	:	1124030721
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNION CHIROPRACTIC CENTER PC

Provider Business Mailing Address
First Line	:	418 CHESTNUT ST
Second Line	:	STE C
City	:	UNION
State	:	NJ
Zip	:	07083-9306
Country	:	US
Telephone Number	:	908-810-9002
Fax Number	:	908-810-9012

Provider Business Practice Location Address
First Line	:	418 CHESTNUT ST
Second Line	:	STE C
City	:	UNION
State	:	NJ
Zip	:	07083-9306
Country	:	US
Telephone Number	:	908-810-9002
Fax Number	:	908-810-9012

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JEANINE GOLDEN
Credential	:
Telephone Number	:	908-810-9002

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	12/11/2024

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Directions to “UNION CHIROPRACTIC CENTER PC ” Practice Location

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