Provider Demographics
NPI:1003930330
Name:MELISSA L. BAUCH
Entity Type:Organization
Organization Name:MELISSA L. BAUCH
Other - Org Name:ALIGN CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:LEMAIRE
Authorized Official - Last Name:BAUCH-MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-652-9590
Mailing Address - Street 1:385 S MAPLE AVE
Mailing Address - Street 2:SUITE 111
Mailing Address - City:GLEN ROCK
Mailing Address - State:NJ
Mailing Address - Zip Code:07452-1543
Mailing Address - Country:US
Mailing Address - Phone:201-652-9590
Mailing Address - Fax:201-652-9570
Practice Address - Street 1:385 S MAPLE AVE
Practice Address - Street 2:SUITE 111
Practice Address - City:GLEN ROCK
Practice Address - State:NJ
Practice Address - Zip Code:07452-1543
Practice Address - Country:US
Practice Address - Phone:201-652-9590
Practice Address - Fax:201-652-9570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC 05093111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU69733Medicare UPIN
NJ005922Medicare PIN