Healthcare Provider Details

I. General information

NPI: 1205963618
Provider Name (Legal Business Name): MICHAEL JOSEPH COONEY DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 UNION AVE
RUTHERFORD NJ
07070
US

IV. Provider business mailing address

323 UNION AVE
RUTHERFORD NJ
07070
US

V. Phone/Fax

Practice location:
  • Phone: 201-933-4440
  • Fax: 201-933-8159
Mailing address:
  • Phone: 201-933-4440
  • Fax: 201-933-8159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00163100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: