Healthcare Provider Details

I. General information

NPI: 1912712704
Provider Name (Legal Business Name): ABANOUB NAIM GUERGES DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2025
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3443 ROUTE 9 N
FREEHOLD NJ
07728-9153
US

IV. Provider business mailing address

3443 ROUTE 9 N
FREEHOLD NJ
07728-9153
US

V. Phone/Fax

Practice location:
  • Phone: 732-836-8065
  • Fax:
Mailing address:
  • Phone: 732-836-8065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number38MC00811800
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00811800
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number38MC00811800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: