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General NPI Number Information
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NPI Number | 1730921248
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Entity Type | Organization
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Legal Business Name | MICHAEL E. ROUSKAS D.C. LLC
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Dates
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Enumeration Date | 06/07/2024
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 1275 BLOOMFIELD AVENUE BUILDING 20, UNIT 146
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City | FAIRFIELD
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State | NJ
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Zip | 07004
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Country | US
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Telephone | 973-996-0061
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Fax |
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Provider Business Mailing Address
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Address Line | 1275 BLOOMFIELD AVENUE BUILDING 20, UNIT 146
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City | FAIRFIELD
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State | NJ
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Zip | 07004
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Country | US
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Telephone | 973-996-0061
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL E. ROUSKAS
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Credential | DC
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Telephone | 973-452-8272
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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 |
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License Number State |
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