Healthcare Provider Details
I. General information
NPI: 1669644076
Provider Name (Legal Business Name): PRECISION FAMILY HEALTH, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/25/2008
Last Update Date: 04/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
141 LINCOLN ST
HACKENSACK NJ
07601-2934
US
IV. Provider business mailing address
141 LINCOLN ST
HACKENSACK NJ
07601
US
V. Phone/Fax
- Phone: 201-965-0534
- Fax: 201-343-0023
- Phone: 201-965-0534
- Fax: 201-343-0023
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QH0100X |
| Taxonomy | Health Service Clinic/Center |
| License Number | 38MC00647800 |
| License Number State | NJ |
VIII. Authorized Official
Name: DR.
JERRY
MICHAEL
MENDEZ
Title or Position: OWNER/CHIROPRACTOR
Credential: D.C.
Phone: 201-595-9559