Healthcare Provider Details

I. General information

NPI: 1700355880
Provider Name (Legal Business Name): NEW JERSEY HEALTH PERFORMANCE INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2018
Last Update Date: 10/26/2021
Certification Date: 10/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 RUES LN
EAST BRUNSWICK NJ
08816-3755
US

IV. Provider business mailing address

21 FELLS DR
MANALAPAN NJ
07726-4153
US

V. Phone/Fax

Practice location:
  • Phone: 908-907-0746
  • Fax:
Mailing address:
  • Phone: 908-907-0746
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JARED BORNSTEIN
Title or Position: OWNER
Credential: DC
Phone: 908-907-0746