Healthcare Provider Details
I. General information
NPI: 1780726463
Provider Name (Legal Business Name): ASSOCIATES IN CHIROPRACTIC FAMILY HEALTH & WELLNESS CENTER, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/12/2007
Last Update Date: 09/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
381 PARK ST SUITE 2A
HACKENSACK NJ
07601-4350
US
IV. Provider business mailing address
381 PARK ST SUITE 2A
HACKENSACK NJ
07601-4350
US
V. Phone/Fax
- Phone: 201-342-6111
- Fax: 201-342-9117
- Phone: 201-342-6111
- Fax: 204-342-9117
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NR0400X |
| Taxonomy | Rehabilitation Chiropractor |
| License Number | 1301 |
| License Number State | NJ |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: DR.
ALBERT
STABILE
JR.
Title or Position: PRES.
Credential: D.C.
Phone: 201-342-6111