MEDICARE: MICHAEL J BOZAN DC 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	111N00000X	Chiropractor	38MC00462300	NJ

General Provider Information

NPI Number	:	1376946046
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL J BOZAN DC PC

Provider Business Mailing Address
First Line	:	237 PARK AVE
Second Line	:
City	:	EAST RUTHERFORD
State	:	NJ
Zip	:	07073-1918
Country	:	US
Telephone Number	:	201-438-7474
Fax Number	:	201-438-8255

Provider Business Practice Location Address
First Line	:	237 PARK AVE
Second Line	:
City	:	EAST RUTHERFORD
State	:	NJ
Zip	:	07073-1918
Country	:	US
Telephone Number	:	201-438-7474
Fax Number	:	201-438-8255

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	MICHAEL J BOZAN
Credential	:	DC
Telephone Number	:	201-438-7474

Provider Enumeration Date	:	10/08/2014
Last Update Date	:	10/08/2014

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