Healthcare Provider Details

I. General information

NPI: 1194883249
Provider Name (Legal Business Name): GINO S RAMUNDO FAMILY CHIROPRACTOR PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 07/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9226 KENNEDY BLVD 2ND FLR
NORTH BERGEN NJ
07047-5312
US

IV. Provider business mailing address

9226 KENNEDY BLVD 2ND FLR
NORTH BERGEN NJ
07047-5312
US

V. Phone/Fax

Practice location:
  • Phone: 201-861-4447
  • Fax: 201-861-3330
Mailing address:
  • Phone: 201-861-4447
  • Fax: 201-861-3330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: GINO S RAMUNDO
Title or Position: PRESIDENT
Credential: DC
Phone: 201-943-1444