Provider Demographics
NPI:1134329618
Name:QUALITY CHIROPRACTIC,LLC
Entity Type:Organization
Organization Name:QUALITY CHIROPRACTIC,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:NIERVA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-549-3993
Mailing Address - Street 1:3830 PARK AVE
Mailing Address - Street 2:207
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-2562
Mailing Address - Country:US
Mailing Address - Phone:732-549-3993
Mailing Address - Fax:732-549-3991
Practice Address - Street 1:3830 PARK AVE
Practice Address - Street 2:207
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-2562
Practice Address - Country:US
Practice Address - Phone:732-549-3993
Practice Address - Fax:732-549-3991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00607900261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU93566Medicare UPIN