=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982868931
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JOSEPH F. BEDNAR, DC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/17/2008
-----------------------------------------------------
Last Update Date | 07/18/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 180 FRANKLIN TPKE
-----------------------------------------------------
City | MAHWAH
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07430-1306
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-529-9330
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 180 FRANKLIN TPKE
-----------------------------------------------------
City | MAHWAH
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07430-1306
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-529-9330
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. JOSEPH F BEDNAR
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 201-529-9330
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 38MC00240000
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------