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General NPI Number Information
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NPI Number | 1023403722
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Entity Type | Organization
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Legal Business Name | NEW JERSEY SPINE AND WELLNESS CENTER LLC
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Dates
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Enumeration Date | 03/31/2015
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Last Update Date | 03/10/2022
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Provider Practice Location Address
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Address Line | 502 HAMBURG TPKE STE 203A
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City | WAYNE
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State | NJ
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Zip | 07470-8446
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Country | US
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Telephone | 973-747-6346
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Fax |
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Provider Business Mailing Address
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Address Line | 61 LAKE TRL E
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City | WAYNE
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State | NJ
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Zip | 07470-4447
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Country | US
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Telephone | 908-770-1325
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Fax |
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | DR. NICHOLAS A CAROFILIS
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Credential | DC
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Telephone | 973-747-6346
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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