Provider Demographics
NPI:1043557325
Name:DR. GORKY F. MASSACHE, D.C., P.C.
Entity Type:Organization
Organization Name:DR. GORKY F. MASSACHE, D.C., P.C.
Other - Org Name:PARSIPPANY CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-808-8660
Mailing Address - Street 1:239 NEW RD
Mailing Address - Street 2:SUITE C302
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-4274
Mailing Address - Country:US
Mailing Address - Phone:973-808-8660
Mailing Address - Fax:973-808-1468
Practice Address - Street 1:239 NEW RD
Practice Address - Street 2:SUITE C302
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-4274
Practice Address - Country:US
Practice Address - Phone:973-808-8660
Practice Address - Fax:973-808-1468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00556400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU79172Medicare UPIN
NJ035801Medicare PIN