Healthcare Provider Details

I. General information

NPI: 1982601845
Provider Name (Legal Business Name): PETER J. HAIGNEY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2005
Last Update Date: 01/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 PARK ST
MONTCLAIR NJ
07042-5907
US

IV. Provider business mailing address

70 PARK ST
MONTCLAIR NJ
07042-5907
US

V. Phone/Fax

Practice location:
  • Phone: 973-746-7766
  • Fax: 973-746-7885
Mailing address:
  • Phone: 973-746-7766
  • Fax: 973-746-7885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License NumberMCOO1767
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: