1750493318 NPI number — CHIROPRACTIC AND REHAB CENTER OF SOUTH JERSEY

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 1750493318 NPI number — CHIROPRACTIC AND REHAB CENTER OF SOUTH JERSEY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHIROPRACTIC AND REHAB CENTER OF SOUTH JERSEY
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:
6
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:
1750493318
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/18/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1937 BERLIN RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHERRY HILL
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08003-3737
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-616-0610
Provider Business Mailing Address Fax Number:
856-616-0607

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1937 HADDONFIELD BERLIN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHERRY HILL
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08003-3737
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-616-0614
Provider Business Practice Location Address Fax Number:
856-616-0607
Provider Enumeration Date:
08/31/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ALBERTI
Authorized Official First Name:
STEVE
Authorized Official Middle Name:
APITCHED
Authorized Official Title or Position:
OWNER/MEMBER
Authorized Official Telephone Number:
856-616-0610

Provider Taxonomy Codes

  • Taxonomy code: 133V00000X , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 171100000X , with the licence number: 25MZ00032700 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: 40QA00696200 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 111N00000X , with the licence number: MC005068 , 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)