Healthcare Provider Details

I. General information

NPI: 1144346511
Provider Name (Legal Business Name): CHIROPRACTIC HEALTH ASSOCIATES OF NEW JERSEY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 06/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 PIERSON AVE SUITE 101
EDISON NJ
08837-3118
US

IV. Provider business mailing address

295 PIERSON AVE SUITE 101
EDISON NJ
08837-3118
US

V. Phone/Fax

Practice location:
  • Phone: 732-738-1800
  • Fax: 732-738-8110
Mailing address:
  • Phone: 732-738-1800
  • Fax: 732-738-8110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00324500
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number25MZ00072200
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberMB06389400
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA01424700
License Number StateNJ

VIII. Authorized Official

Name: DR. DOUGLAS J. ZIMMEL
Title or Position: CHIROPRACTOR/OWNER
Credential: DC
Phone: 732-738-1800