Provider Demographics
NPI:1275652828
Name:VANSETERS, GEORGE JAY (DC)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:JAY
Last Name:VANSETERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 NEWARK POMPTON TPKE
Mailing Address - Street 2:
Mailing Address - City:PEQUANNOCK
Mailing Address - State:NJ
Mailing Address - Zip Code:07440-1623
Mailing Address - Country:US
Mailing Address - Phone:973-694-3209
Mailing Address - Fax:973-872-9909
Practice Address - Street 1:40 NEWARK POMPTON TPKE
Practice Address - Street 2:
Practice Address - City:PEQUANNOCK
Practice Address - State:NJ
Practice Address - Zip Code:07440-1623
Practice Address - Country:US
Practice Address - Phone:973-694-3209
Practice Address - Fax:973-872-9909
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ3223111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ470353Medicare ID - Type UnspecifiedEMPIRE MDICARE SERVICES