MEDICARE: DR. JOHN KANE DC

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	38MC00287800	NJ

General Provider Information

NPI Number	:	1639262512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN KANE DC

Provider Business Mailing Address
First Line	:	495 WATCHUNG AVE
Second Line	:
City	:	BLOOMFIELD
State	:	NJ
Zip	:	07003-2942
Country	:	US
Telephone Number	:	973-338-4100
Fax Number	:

Provider Business Practice Location Address
First Line	:	495 WATCHUNG AVE
Second Line	:
City	:	BLOOMFIELD
State	:	NJ
Zip	:	07003-2942
Country	:	US
Telephone Number	:	973-338-4100
Fax Number	:	973-337-2438

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	01/04/2017

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