Provider Demographics
NPI:1033316617
Name:BOURNE, SHERIN (DC)
Entity Type:Individual
Prefix:DR
First Name:SHERIN
Middle Name:
Last Name:BOURNE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21B STANGL RD
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-1582
Mailing Address - Country:US
Mailing Address - Phone:908-722-2274
Mailing Address - Fax:908-722-7399
Practice Address - Street 1:3322 US HIGHWAY 22 WEST
Practice Address - Street 2:SUITE 1106
Practice Address - City:BRANCHBURG
Practice Address - State:NJ
Practice Address - Zip Code:08876-3476
Practice Address - Country:US
Practice Address - Phone:908-722-2274
Practice Address - Fax:908-722-7399
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ332238MC00630700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ086897Medicare ID - Type Unspecified
NJ800114346Medicare UPIN