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General NPI Number Information
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NPI Number | 1255046702
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Entity Type | Organization
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Legal Business Name | CORE 44 LLC
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Dates
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Enumeration Date | 01/19/2023
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Last Update Date | 05/22/2023
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Provider Practice Location Address
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Address Line | 18 FURLER ST
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City | TOTOWA
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State | NJ
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Zip | 07512-2765
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Country | US
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Telephone | 973-200-0170
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11004
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City | FAIRFIELD
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State | NJ
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Zip | 07004-7004
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Country | US
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Telephone | 973-200-0170
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Fax |
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | DR. ANTHONY GENCARELLI
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Credential | DC
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Telephone | 973-200-0170
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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 |
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License Number State |
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