MEDICARE: CHIROPRACTIC & REHABILITATION CENTER PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NR0400X	Rehabilitation Chiropractor	38MC00505700	NJ

General Provider Information

NPI Number	:	1376758441
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHIROPRACTIC & REHABILITATION CENTER PC

Provider Business Mailing Address
First Line	:	517 RIVER DR STE 2A
Second Line	:
City	:	GARFIELD
State	:	NJ
Zip	:	07026-3270
Country	:	US
Telephone Number	:	973-955-0755
Fax Number	:	973-955-0753

Provider Business Practice Location Address
First Line	:	517 RIVER DR STE 2A
Second Line	:
City	:	GARFIELD
State	:	NJ
Zip	:	07026-3270
Country	:	US
Telephone Number	:	973-955-0755
Fax Number	:	973-955-0753

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. MARYANN VIVOLO-SCLAFANI
Credential	:
Telephone Number	:	973-955-0755

Provider Enumeration Date	:	05/11/2007
Last Update Date	:	07/21/2022

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