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General NPI Number Information
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NPI Number | 1033251640
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Entity Type | Individual
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Provider Name | GEORGE J LUBERTAZZO D.C.
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Gender | Male
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 01/13/2014
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Provider Practice Location Address
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Address Line | 39 MEADOW RD
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City | RUTHERFORD
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State | NJ
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Zip | 07070-2009
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Country | US
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Telephone | 201-896-0068
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Fax | 201-842-1709
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Provider Business Mailing Address
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Address Line | P.O. BOX 1727
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City | RUTHERFORD
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State | NJ
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Zip | 07070-2009
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Country | US
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Telephone | 201-896-0068
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Fax | 201-842-1709
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 38MC00354700
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License Number State | NJ
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