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General NPI Number Information
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NPI Number | 1376946046
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Entity Type | Organization
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Legal Business Name | MICHAEL J BOZAN DC PC
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Dates
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Enumeration Date | 10/08/2014
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Last Update Date | 10/08/2014
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Provider Practice Location Address
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Address Line | 237 PARK AVE
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City | EAST RUTHERFORD
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State | NJ
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Zip | 07073-1918
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Country | US
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Telephone | 201-438-7474
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Fax | 201-438-8255
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Provider Business Mailing Address
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Address Line | 237 PARK AVE
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City | EAST RUTHERFORD
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State | NJ
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Zip | 07073-1918
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Country | US
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Telephone | 201-438-7474
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Fax | 201-438-8255
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MICHAEL J BOZAN
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Credential | DC
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Telephone | 201-438-7474
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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 | 38MC00462300
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License Number State | NJ
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