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General NPI Number Information
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NPI Number | 1043588569
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Entity Type | Organization
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Legal Business Name | FERRY PAIN & REHAB CENTER
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Dates
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Enumeration Date | 12/12/2011
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Last Update Date | 01/13/2012
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Provider Practice Location Address
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Address Line | 128 FERRY ST
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City | NEWARK
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State | NJ
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Zip | 07105-2115
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Country | US
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Telephone | 973-344-0129
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Fax | 973-344-0243
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Provider Business Mailing Address
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Address Line | 128 FERRY ST
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City | NEWARK
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State | NJ
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Zip | 07105-2115
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Country | US
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Telephone | 973-344-0129
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Fax | 973-344-0243
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Authorized Official
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Title or Position | CHIROPRACTIC PHYSICIAN
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Name | DR. DAVID G. HARRIS
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Credential | DC
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Telephone | 973-344-0129
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 38MC00508400
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 38MC00235500
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License Number State | NJ
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