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NPI Code Detail

MEDICARE: DR. NELLEKE GREENDYK D.C

MEDICARE: DR. NELLEKE GREENDYK D.C
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
1111NN1001XNutrition ChiropractorX004528-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11528135290OTHERNPI

General Provider Information

NPI Number : 1528135290
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NELLEKE GREENDYK D.C
Provider Business Mailing Address
First Line : 13 GLENNON RD
Second Line :
City : WEST MILFORD
State : NJ
Zip : 07480-2708
Country : US
Telephone Number : 973-208-9774
Fax Number :
Provider Business Practice Location Address
First Line : 214 RONALD REAGAN BLVD
Second Line :
City : WARWICK
State : NY
Zip : 10990-4107
Country : US
Telephone Number : 845-986-9222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2006
Last Update Date : 04/07/2009

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Directions to “ DR. NELLEKE GREENDYK D.C” Practice Location

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