Provider Demographics
NPI:1326179805
Name:OLIVIERI CHIROPRACTIC CENTER, LLC
Entity Type:Organization
Organization Name:OLIVIERI CHIROPRACTIC CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:OLIVIERI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:609-886-8585
Mailing Address - Street 1:1501 ROUTE 47
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE
Mailing Address - State:NJ
Mailing Address - Zip Code:08242-1401
Mailing Address - Country:US
Mailing Address - Phone:609-886-8585
Mailing Address - Fax:609-886-8540
Practice Address - Street 1:1501 ROUTE 47
Practice Address - Street 2:
Practice Address - City:RIO GRANDE
Practice Address - State:NJ
Practice Address - Zip Code:08242-1401
Practice Address - Country:US
Practice Address - Phone:609-886-8585
Practice Address - Fax:609-886-8540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00611300111N00000X
NJ38MC00318600111NN0400X, 111NX0800X
NJ40QA00812700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Not Answered111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Multi-Specialty
Not Answered111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Multi-Specialty
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2153352000OtherAMERIHEALTH GROUP NUMBER
NJ2153352000OtherAMERIHEALTH GROUP NUMBER
NJ=========POtherHORIZON BC BS PT
NJ=========OtherHORIZON BC BS CHIRO
NJ076166Medicare ID - Type UnspecifiedGROUP ID NUMBER