Healthcare Provider Details

I. General information

NPI: 1265643233
Provider Name (Legal Business Name): ALBERT STABILE JR. D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

381 PARK ST
HACKENSACK NJ
07601-4350
US

IV. Provider business mailing address

381 PARK ST
HACKENSACK NJ
07601-4350
US

V. Phone/Fax

Practice location:
  • Phone: 201-342-6111
  • Fax:
Mailing address:
  • Phone: 201-342-6111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number38MC00130100
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: