Healthcare Provider Details
I. General information
NPI: 1396750980
Provider Name (Legal Business Name): DOCTORS CARE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/30/2006
Last Update Date: 07/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
901 N WOOD AVE
LINDEN NJ
07036-4039
US
IV. Provider business mailing address
901 N WOOD AVE
LINDEN NJ
07036-4039
US
V. Phone/Fax
- Phone: 908-474-9444
- Fax: 908-620-3744
- Phone: 908-474-9444
- Fax: 908-620-3744
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 38MC00475900 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | 40QA01132800 |
| License Number State | NJ |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | NJ |
VIII. Authorized Official
Name: MRS.
EILEEN
M.
MILLER
Title or Position: OFFICE MANAGER
Credential:
Phone: 908-474-9444