Provider Demographics
NPI:1073012035
Name:KITTATINNY CHIROPRACTIC AND WELLNESS CENTER
Entity Type:Organization
Organization Name:KITTATINNY CHIROPRACTIC AND WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:J
Authorized Official - Last Name:BURRINI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:973-300-5667
Mailing Address - Street 1:222 HIGH ST STE 201B
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07860-9605
Mailing Address - Country:US
Mailing Address - Phone:973-300-5667
Mailing Address - Fax:973-300-1515
Practice Address - Street 1:222 HIGH ST STE 201B
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-9605
Practice Address - Country:US
Practice Address - Phone:973-300-5667
Practice Address - Fax:973-300-1515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-06
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00539100111N00000X
38MC00539100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty