MEDICARE: DR. RICHARD D EDEN DC

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	111N00000X	Chiropractor	38MC00144400	NJ

General Provider Information

NPI Number	:	1265496137
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD D EDEN DC

Provider Business Mailing Address
First Line	:	180 BAYBERRY LN
Second Line	:
City	:	WATCHUNG
State	:	NJ
Zip	:	07069-6106
Country	:	US
Telephone Number	:	908-687-3410
Fax Number	:	908-687-3419

Provider Business Practice Location Address
First Line	:	410 CHESTNUT ST
Second Line	:
City	:	UNION
State	:	NJ
Zip	:	07083-9306
Country	:	US
Telephone Number	:	908-687-3410
Fax Number	:	908-687-3419

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2006
Last Update Date	:	05/04/2009

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Directions to “ DR. RICHARD D EDEN DC” Practice Location

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