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General NPI Number Information
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NPI Number | 1295069003
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Entity Type | Organization
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Legal Business Name | DR JOHN R MORDAGA PC
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Dates
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Enumeration Date | 09/25/2009
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Last Update Date | 09/25/2009
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Provider Practice Location Address
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Address Line | 385 LAKEVIEW AVE
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City | CLIFTON
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State | NJ
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Zip | 07011-4074
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Country | US
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Telephone | 973-772-1004
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Fax | 973-772-9504
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Provider Business Mailing Address
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Address Line | 385 LAKEVIEW AVE
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City | CLIFTON
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State | NJ
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Zip | 07011-4074
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Country | US
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Telephone | 973-772-1004
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Fax | 973-772-9504
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN R MORDAGA
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Credential | DC
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Telephone | 973-772-1004
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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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