=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134334618
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | STEVEN MARK SALBERG D.C.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/10/2007
-----------------------------------------------------
Last Update Date | 07/31/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 425 MAIN ST FL 2
-----------------------------------------------------
City | ORANGE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07050-1503
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-673-4044
-----------------------------------------------------
Fax | 862-444-3756
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 425 MAIN ST FL 2
-----------------------------------------------------
City | ORANGE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07050-1503
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-673-4044
-----------------------------------------------------
Fax | 862-444-3756
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 38MC00227500
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------