Healthcare Provider Details

I. General information

NPI: 1134173305
Provider Name (Legal Business Name): LUCIEN JOSEPH EID D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 04/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 MILLTOWN RD STE 201
NORTH BRUNSWICK NJ
08902-3317
US

IV. Provider business mailing address

525 MILLTOWN RD SUITE 305
NORTH BRUNSWICK NJ
08902-3317
US

V. Phone/Fax

Practice location:
  • Phone: 732-545-3300
  • Fax: 732-545-8829
Mailing address:
  • Phone: 732-545-3300
  • Fax: 732-545-8829

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00559100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: