Provider Demographics
NPI:1164501383
Name:CLIFTON PHYSICIANS HEALTHCARE AND INJURY CENTER LLC
Entity Type:Organization
Organization Name:CLIFTON PHYSICIANS HEALTHCARE AND INJURY CENTER LLC
Other - Org Name:PATTI CHIROPRACTIC ASSOCIATES LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SALVATORE
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:973-772-7073
Mailing Address - Street 1:418 CLIFTON AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-2645
Mailing Address - Country:US
Mailing Address - Phone:973-772-7073
Mailing Address - Fax:973-772-1448
Practice Address - Street 1:418 CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-2645
Practice Address - Country:US
Practice Address - Phone:973-772-7073
Practice Address - Fax:973-772-1448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJPA452095Medicare PIN