Healthcare Provider Details

I. General information

NPI: 1174719744
Provider Name (Legal Business Name): HOBOKEN INTEGRATED HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2007
Last Update Date: 10/19/2023
Certification Date: 10/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 PINE ST
MORRISTOWN NJ
07960-4167
US

IV. Provider business mailing address

10 PINE ST
MORRISTOWN NJ
07960-4167
US

V. Phone/Fax

Practice location:
  • Phone: 973-809-0672
  • Fax: 973-809-0672
Mailing address:
  • Phone: 973-809-0692
  • Fax: 973-090-6728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA00710000
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00326300
License Number StateNJ

VIII. Authorized Official

Name: DR. JOSEPH T CANOVA
Title or Position: OWNER
Credential: D.C.
Phone: 201-798-2922