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General NPI Number Information
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NPI Number | 1952605792
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Entity Type | Organization
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Legal Business Name | BELLEVILLE ACCIDENT AND INJURY RELIEF CENTER LLC
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Dates
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Enumeration Date | 01/10/2011
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Last Update Date | 01/10/2011
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Provider Practice Location Address
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Address Line | 544 WASHINGTON AVE
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City | BELLEVILLE
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State | NJ
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Zip | 07109-3334
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Country | US
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Telephone | 973-759-3020
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Fax |
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Provider Business Mailing Address
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Address Line | 544 WASHINGTON AVE
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City | BELLEVILLE
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State | NJ
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Zip | 07109-3334
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Country | US
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Telephone | 973-759-3020
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. MICHAEL CHILLEMI
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Credential | DC
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Telephone | 973-759-3020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA01281000
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License Number State | NJ
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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 | MC05321
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License Number State | NJ
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