Provider Demographics
NPI:1437321205
Name:HUDAK CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:HUDAK CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:NELAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-661-0800
Mailing Address - Street 1:909 AMBOY AVE
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-2880
Mailing Address - Country:US
Mailing Address - Phone:732-661-0800
Mailing Address - Fax:
Practice Address - Street 1:909 AMBOY AVE
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-2880
Practice Address - Country:US
Practice Address - Phone:732-661-0800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00493900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ893699Medicare PIN