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General NPI Number Information
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NPI Number | 1063435857
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Entity Type | Individual
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Provider Name | LOUIS A GREGORY D.C., L.A.C
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Gender | Male
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 04/02/2015
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Provider Practice Location Address
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Address Line | 851 SPRINGFIELD AVE 15 E
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City | SUMMIT
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State | NJ
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Zip | 07901-1138
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Country | US
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Telephone | 908-374-9399
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Fax |
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Provider Business Mailing Address
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Address Line | 851 SPRINGFIELD AVE 15 E
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City | SUMMIT
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State | NJ
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Zip | 07901-1138
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Country | US
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Telephone | 908-374-9399
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Fax |
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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 | 38MC00621600
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | X008300-1
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License Number State | NY
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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 | DC24964
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 25MZ00108500
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License Number State | NJ
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Taxonomy #5
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC 16353
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License Number State | CA
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