Healthcare Provider Details

I. General information

NPI: 1225102965
Provider Name (Legal Business Name): CORRECTIVE CARE GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 09/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 WEST PROSPECT ST
EAST BRUNSWICK NJ
08816-2118
US

IV. Provider business mailing address

67 WEST PROSPECT ST
EAST BRUNSWICK NJ
08816-2118
US

V. Phone/Fax

Practice location:
  • Phone: 732-613-6000
  • Fax: 732-613-6007
Mailing address:
  • Phone: 732-613-6000
  • Fax: 732-613-6007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number46TR00414100
License Number StateNJ

VIII. Authorized Official

Name: DR. ALAN J WOLKOFF
Title or Position: PRESIDENT
Credential: DC
Phone: 732-613-6000