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General NPI Number Information
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NPI Number | 1104329374
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Entity Type | Organization
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Legal Business Name | EVEREST CHIROPRACTIC PC
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Dates
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Enumeration Date | 03/14/2018
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Last Update Date | 03/14/2018
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Provider Practice Location Address
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Address Line | 200 SHEFFIELD ST STE 303
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City | MOUNTAINSIDE
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State | NJ
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Zip | 07092-2314
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Country | US
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Telephone | 908-505-0992
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Fax | 646-626-6370
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Provider Business Mailing Address
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Address Line | 200 SHEFFIELD ST STE 303
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City | MOUNTAINSIDE
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State | NJ
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Zip | 07092-2314
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Country | US
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Telephone | 908-505-0992
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Fax | 646-626-6370
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Authorized Official
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Title or Position | OWNER
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Name | DR. GABRIEL NADEL
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Credential | DC
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Telephone | 908-505-0992
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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 | 38MC00731300
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License Number State | NJ
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