Provider Demographics
NPI:1124030721
Name:UNION CHIROPRACTIC CENTER PC
Entity Type:Organization
Organization Name:UNION CHIROPRACTIC CENTER PC
Other - Org Name:UNION SPINE & WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEANINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-810-9002
Mailing Address - Street 1:418 CHESTNUT ST
Mailing Address - Street 2:STE C
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-9306
Mailing Address - Country:US
Mailing Address - Phone:908-810-9002
Mailing Address - Fax:908-810-9012
Practice Address - Street 1:418 CHESTNUT ST
Practice Address - Street 2:STE C
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-9306
Practice Address - Country:US
Practice Address - Phone:908-810-9002
Practice Address - Fax:908-810-9012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00603500111N00000X
NJ40QA01162800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1523495OtherAMERICHOICE
NJ9284171003OtherCONNECTICUT GENERAL INS
NJ3325455OtherAETNA HMO
NJ2K5605OtherHEALTHNET
NJP2752095OtherOXFORD
NJ1523495OtherAMERICHOICE
NJU84207Medicare UPIN