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General NPI Number Information
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NPI Number | 1629217401
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Entity Type | Organization
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Legal Business Name | FLEXCHIROPRACTIC
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Dates
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Enumeration Date | 02/18/2009
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Last Update Date | 02/18/2009
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Provider Practice Location Address
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Address Line | 720 WASHINGTON AVE
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City | BELLEVILLE
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State | NJ
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Zip | 07109-2871
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Country | US
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Telephone | 973-844-1155
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 659
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City | TOTOWA
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State | NJ
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Zip | 07511-0659
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Country | US
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Telephone | 973-844-1155
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FRANK NICOSIA
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Credential |
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Telephone | 973-844-1155
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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 | 38MC00574800
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License Number State | NJ
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