Healthcare Provider Details

I. General information

NPI: 1902012578
Provider Name (Legal Business Name): MANALAPAN SPINE CARE AND REHABILITATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 12/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94 BRIDGE PLAZA DR
MANALAPAN NJ
07726-1700
US

IV. Provider business mailing address

94 BRIDGE PLAZA DR
MANALAPAN NJ
07726-1700
US

V. Phone/Fax

Practice location:
  • Phone: 732-972-5900
  • Fax:
Mailing address:
  • Phone: 732-972-5900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00567900
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA01080900
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA00981100
License Number StateNJ

VIII. Authorized Official

Name: DR. PAUL JOHN BATTIPAGLIA
Title or Position: OWNER
Credential: CHIROPRACTOR
Phone: 732-972-5900