MEDICARE: PATERSON CHIROPRACTIC AND PHYSICAL THERAPY

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	261QP2000X	Physical Therapy Clinic/Center	38MC0052900	NJ

General Provider Information

NPI Number	:	1750872719
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATERSON CHIROPRACTIC AND PHYSICAL THERAPY

Provider Business Mailing Address
First Line	:	PO BOX 503
Second Line	:
City	:	SADDLE BROOK
State	:	NJ
Zip	:	07663-0503
Country	:	US
Telephone Number	:	973-345-2800
Fax Number	:	973-345-2807

Provider Business Practice Location Address
First Line	:	345 BROADWAY FL 1
Second Line	:
City	:	PATERSON
State	:	NJ
Zip	:	07501-2102
Country	:	US
Telephone Number	:	973-345-2800
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MICHAEL MANNO
Credential	:	DC
Telephone Number	:	973-345-2800

Provider Enumeration Date	:	05/25/2018
Last Update Date	:	10/19/2022

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Directions to “PATERSON CHIROPRACTIC AND PHYSICAL THERAPY ” Practice Location

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