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General NPI Number Information
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NPI Number | 1154473734
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Entity Type | Organization
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Legal Business Name | UNITED DIAGNOSTIC ASSOCIATES, LLC
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 16 CORNELL DR
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City | LIVINGSTON
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State | NJ
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Zip | 07039-5518
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Country | US
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Telephone | 888-683-5572
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Fax | 888-683-5572
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Provider Business Mailing Address
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Address Line | 16 CORNELL DR
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City | LIVINGSTON
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State | NJ
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Zip | 07039-5518
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DANIEL HOUSHMAND
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Credential | D.C., D.I.B.E.
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Telephone | 888-683-5572
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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 | 38MC00567300
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License Number State | NJ
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