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General NPI Number Information
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NPI Number | 1831386440
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Entity Type | Organization
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Legal Business Name | THE BACK CARE CENTER IN TENAFLY LLC
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Dates
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Enumeration Date | 09/27/2007
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Last Update Date | 09/27/2007
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Provider Practice Location Address
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Address Line | 103 N SUMMIT STREET
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City | TENAFLY
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State | NJ
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Zip | 07670
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Country | US
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Telephone | 201-227-1366
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Fax |
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Provider Business Mailing Address
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Address Line | 89 GRANT AVENUE
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City | DUMONT
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State | NJ
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Zip | 07628
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Country | US
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Telephone | 201-387-7463
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Fax | 201-387-2360
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. DAVID BARRY SCHWARTZ
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Credential | DC
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Telephone | 201-227-1366
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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 | X00468641
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | MC00333700
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License Number State | NJ
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