Healthcare Provider Details

I. General information

NPI: 1659305290
Provider Name (Legal Business Name): PAUL FRANCIS MARSTON D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 08/13/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 KAKEOUT RD SUITE B
KINNELON NJ
07405-2548
US

IV. Provider business mailing address

300 KAKEOUT RD SUITE B
KINNELON NJ
07405
US

V. Phone/Fax

Practice location:
  • Phone: 973-838-6252
  • Fax: 973-838-4159
Mailing address:
  • Phone: 973-838-6252
  • Fax: 973-838-4159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberMC3989
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberMC3989
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: