MEDICARE: NICHOLAS F. STABILE, 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	MC005796	NJ

General Provider Information

NPI Number	:	1487664652
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NICHOLAS F. STABILE, DC, PC

Provider Business Mailing Address
First Line	:	187 WASHINGTON AVE STE 2B
Second Line	:
City	:	NUTLEY
State	:	NJ
Zip	:	07110-1995
Country	:	US
Telephone Number	:	973-661-0500
Fax Number	:	973-661-0562

Provider Business Practice Location Address
First Line	:	187 WASHINGTON AVE STE 2B
Second Line	:
City	:	NUTLEY
State	:	NJ
Zip	:	07110-1995
Country	:	US
Telephone Number	:	973-661-0500
Fax Number	:	973-661-0562

Authorized Official
Title or Position	:	OWNER
Name	:	DR. NICHOLAS FRANK STABILE
Credential	:	DC
Telephone Number	:	973-661-0500

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	04/22/2024

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