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General NPI Number Information
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NPI Number | 1407963887
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Entity Type | Individual
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Provider Name | DAVID PODELL DC
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Gender | Male
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 115 RIVER RD SUITE 1032 3RD FLOOR BLDG 10
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City | EDGEWATER
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State | NJ
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Zip | 07020-1034
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Country | US
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Telephone | 201-840-1980
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Fax | 201-840-1987
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Provider Business Mailing Address
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Address Line | 115 RIVER RD SUITE 1032 3RD FLOOR BLDG 10
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City | EDGEWATER
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State | NJ
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Zip | 07020-1034
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Country | US
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Telephone | 201-840-1980
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Fax | 201-840-1987
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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 | 2021
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License Number State | NJ
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