Provider Demographics
NPI:1235185703
Name:THE CHIROPRACTIC & PHYSICAL THERAPY CENTER OF NJ PC
Entity Type:Organization
Organization Name:THE CHIROPRACTIC & PHYSICAL THERAPY CENTER OF NJ PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHILLEMI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:973-759-3020
Mailing Address - Street 1:544 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-3334
Mailing Address - Country:US
Mailing Address - Phone:973-759-3020
Mailing Address - Fax:973-759-2046
Practice Address - Street 1:544 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-3334
Practice Address - Country:US
Practice Address - Phone:973-759-3020
Practice Address - Fax:973-759-2046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00532100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJPENDINGOtherCHIRO PT