Provider Demographics
NPI:1275881856
Name:KOSTINAS CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:KOSTINAS CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:KOSTINAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:609-883-2225
Mailing Address - Street 1:143 UPPER FERRY RD
Mailing Address - Street 2:
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08628-1528
Mailing Address - Country:US
Mailing Address - Phone:609-883-2225
Mailing Address - Fax:
Practice Address - Street 1:143 UPPER FERRY RD
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08628-1528
Practice Address - Country:US
Practice Address - Phone:609-883-2225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-29
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00315700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty