Healthcare Provider Details

I. General information

NPI: 1538363338
Provider Name (Legal Business Name): JOSHUA DUFFY DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 LAFAYETTE AVE
HAWTHORNE NJ
07506-1904
US

IV. Provider business mailing address

1021 CUMBERLAND CT
MAHWAH NJ
07430-1358
US

V. Phone/Fax

Practice location:
  • Phone: 973-423-9100
  • Fax: 973-423-1339
Mailing address:
  • Phone: 201-252-2526
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00607700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: