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General NPI Number Information
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NPI Number | 1376853176
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Entity Type | Individual
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Provider Name | LEAH VAN BLARCOM D.C.
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Gender | Female
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Dates
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Enumeration Date | 10/14/2010
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Last Update Date | 09/20/2019
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Provider Practice Location Address
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Address Line | 500 BARNETT PL
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City | HO HO KUS
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State | NJ
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Zip | 07423-1564
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Country | US
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Telephone | 201-777-0770
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Fax | 201-445-2950
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Provider Business Mailing Address
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Address Line | 500 BARNETT PL
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City | HO HO KUS
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State | NJ
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Zip | 07423-1564
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Country | US
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Telephone | 201-777-0770
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Fax | 201-445-2950
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | X012068-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 38MC00699600
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License Number State | NJ
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