1528307485 NPI number — FLEMINGTON CHIROPRACTIC CENTER, P.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528307485 NPI number — FLEMINGTON CHIROPRACTIC CENTER, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FLEMINGTON CHIROPRACTIC CENTER, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528307485
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/09/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
105 HWY 31
Provider Second Line Business Mailing Address:
104
Provider Business Mailing Address City Name:
FLEMINGTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08822-5772
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-806-3040
Provider Business Mailing Address Fax Number:
908-806-3050

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
105 HWY 31 STE 103
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLEMINGTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08822-5745
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-806-3040
Provider Business Practice Location Address Fax Number:
908-806-3050
Provider Enumeration Date:
02/12/2013

Additional Information

Authorized Official

Authorized Official Last Name:
MANSUETO
Authorized Official First Name:
LINDSEY
Authorized Official Middle Name:
U
Authorized Official Title or Position:
CHIROPRACTIC PHYSICIAN- CEO
Authorized Official Telephone Number:
908-806-3040

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  38MC00703600 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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