=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821101940
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SONAL DALAL DC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/15/2006
-----------------------------------------------------
Last Update Date | 11/03/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 415 MAIN ST
-----------------------------------------------------
City | CHATHAM
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07928-2105
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-635-2290
-----------------------------------------------------
Fax | 973-635-8342
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 415 MAIN STREET
-----------------------------------------------------
City | CHATHAM
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07928-2105
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-635-2290
-----------------------------------------------------
Fax | 973-635-8342
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 38MC00369900
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------