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General NPI Number Information
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NPI Number | 1225431182
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Entity Type | Individual
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Provider Name | DEBRA MAIBACH
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Gender | Female
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Dates
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Enumeration Date | 10/06/2014
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Last Update Date | 10/06/2014
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Provider Practice Location Address
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Address Line | 1390 VALLEY RD
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City | STIRLING
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State | NJ
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Zip | 07980-1346
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Country | US
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Telephone | 908-903-0111
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Fax |
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Provider Business Mailing Address
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Address Line | 82 N FINLEY AVE
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City | BASKING RIDGE
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State | NJ
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Zip | 07920-1158
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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 |
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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 | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | 38MC00467300
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License Number State | NJ
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