Healthcare Provider Details
I. General information
NPI: 1003128513
Provider Name (Legal Business Name): DR. MARTIN RICHARD ZIPKIN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/13/2010
Last Update Date: 04/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15 HAMILTON DR
EAST BRUNSWICK NJ
08816-2710
US
IV. Provider business mailing address
15 HAMILTON DR
EAST BRUNSWICK NJ
08816-2710
US
V. Phone/Fax
- Phone: 732-613-6048
- Fax:
- Phone: 732-221-2638
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NR0400X |
| Taxonomy | Rehabilitation Chiropractor |
| License Number | MCO2743 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: