Healthcare Provider Details

I. General information

NPI: 1134278807
Provider Name (Legal Business Name): JEFFREY JORDAN HUREWITZ D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 08/26/2020
Certification Date: 08/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1999 ROUTE 88
BRICK NJ
08724-3152
US

IV. Provider business mailing address

1999 ROUTE 88
BRICK NJ
08724-3152
US

V. Phone/Fax

Practice location:
  • Phone: 732-903-2222
  • Fax: 732-903-2111
Mailing address:
  • Phone: 732-903-2222
  • Fax: 732-903-2111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00655000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: