Healthcare Provider Details
I. General information
NPI: 1124322615
Provider Name (Legal Business Name): ESTHER RUTH STARR D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/27/2010
Last Update Date: 01/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
205 ROBIN RD. PARAMUS MEDICAL AND REHABILITATION CENTER SUITE 118
PARAMUS NJ
07652-3904
US
IV. Provider business mailing address
642 KENNEDY DR
TOWNSHIP OF WASHINGTON NJ
07676-4103
US
V. Phone/Fax
- Phone: 201-225-1511
- Fax: 201-225-9731
- Phone: 201-666-0565
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 38MC00228600 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 3389 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: