=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750451431
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALTERNATIVE CHIROPRACTIC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/09/2006
-----------------------------------------------------
Last Update Date | 06/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1011 CLIFTON AVE STE 1F
-----------------------------------------------------
City | CLIFTON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07013-3518
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-779-2466
-----------------------------------------------------
Fax | 973-779-4943
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1011 CLIFTON AVE STE 2B
-----------------------------------------------------
City | CLIFTON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07013-3518
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-779-2466
-----------------------------------------------------
Fax | 973-779-4943
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER - CHIROPRACTOR
-----------------------------------------------------
Name | DR. ANDREAS SKOUNAKIS
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 973-779-2466
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111NX0100X
-----------------------------------------------------
Taxonomy Name | Occupational Health Chiropractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------