Provider Demographics
NPI:1285815431
Name:GEWANT, BRETT WAYNE (DC)
Entity Type:Individual
Prefix:DR
First Name:BRETT
Middle Name:WAYNE
Last Name:GEWANT
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 1:229 DAYTON AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-1551
Mailing Address - Country:US
Mailing Address - Phone:973-478-2121
Mailing Address - Fax:973-478-1311
Practice Address - Street 1:229 DAYTON AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-1551
Practice Address - Country:US
Practice Address - Phone:973-478-2121
Practice Address - Fax:973-478-1311
Is Sole Proprietor?:No
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC003894111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor