Healthcare Provider Details

I. General information

NPI: 1932686185
Provider Name (Legal Business Name): WEYL CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2018
Last Update Date: 07/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 GARBER SQ STE 1
RIDGEWOOD NJ
07450-3129
US

IV. Provider business mailing address

PO BOX 629
FRANKLIN LAKES NJ
07417-0629
US

V. Phone/Fax

Practice location:
  • Phone: 201-652-7888
  • Fax:
Mailing address:
  • Phone: 201-847-8079
  • Fax: 201-847-0059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number25MZ00011200
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00305500
License Number StateNJ

VIII. Authorized Official

Name: STEVEN WEYL
Title or Position: PRESIDENT
Credential: DC
Phone: 201-847-8079