Healthcare Provider Details

I. General information

NPI: 1124215355
Provider Name (Legal Business Name): RIVER VALE CHIROPRACTIC CENTER P. A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2007
Last Update Date: 10/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

674 WESTWOOD AVE
RIVERVALE NJ
07675-6307
US

IV. Provider business mailing address

674 WESTWOOD AVE
RIVERVALE NJ
07675-6307
US

V. Phone/Fax

Practice location:
  • Phone: 201-666-5300
  • Fax: 201-666-4951
Mailing address:
  • Phone: 201-666-5300
  • Fax: 201-666-4951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. CHARLES SCOTT BERG
Title or Position: OWNER
Credential: D.C.
Phone: 201-666-5300