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General NPI Number Information
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NPI Number | 1700418449
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Entity Type | Individual
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Provider Name | GAGE KIRSTEIN DC
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Gender | Male
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Dates
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Enumeration Date | 02/11/2020
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Last Update Date | 02/11/2020
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Provider Practice Location Address
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Address Line | 630 S BREWSTER RD STE B2
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City | VINELAND
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State | NJ
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Zip | 08361-7801
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Country | US
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Telephone | 856-692-9299
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Fax |
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Provider Business Mailing Address
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Address Line | 1161 MORTON AVE
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City | PITTSGROVE
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State | NJ
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Zip | 08318-4059
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Country | US
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Telephone | 856-332-8112
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Fax |
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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 | 38MC00768900
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License Number State | NJ
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