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General NPI Number Information
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NPI Number | 1558404848
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Entity Type | Individual
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Provider Name | GINA M. POLETTI-LECKBURG D.C.
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Gender | Female
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 648 US HIGHWAY 206
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City | HILLSBOROUGH
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State | NJ
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Zip | 08844-1511
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Country | US
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Telephone | 908-874-5402
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Fax | 908-874-0651
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Provider Business Mailing Address
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Address Line | 648 US HIGHWAY 206 SOUTH
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City | HILLSBOROUGH
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State | NJ
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Zip | 08844-1511
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Country | US
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Telephone | 908-874-5402
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Fax | 908-874-0651
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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 | 2471
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License Number State | NJ
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