Healthcare Provider Details

I. General information

NPI: 1235290552
Provider Name (Legal Business Name): JAMES HERZOG DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3499 ROUTE 9 N
FREEHOLD NJ
07728-3258
US

IV. Provider business mailing address

555 IRON BRIDGE RD SUITE 18
FREEHOLD NJ
07728-2975
US

V. Phone/Fax

Practice location:
  • Phone: 732-431-1126
  • Fax: 732-414-1551
Mailing address:
  • Phone: 732-431-2611
  • Fax: 732-431-5499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License NumberMC3531
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00353100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: