Provider Demographics
NPI:1033483680
Name:TJS CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:TJS CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:SIDOTI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:973-773-2244
Mailing Address - Street 1:180 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-6205
Mailing Address - Country:US
Mailing Address - Phone:973-773-2244
Mailing Address - Fax:973-472-8577
Practice Address - Street 1:180 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-6205
Practice Address - Country:US
Practice Address - Phone:973-773-2244
Practice Address - Fax:973-472-8577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-29
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00292200261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service