Provider Demographics
NPI:1447382262
Name:NUZZI CHIROPRACTIC FAMILY & SPORTS CENTER
Entity Type:Organization
Organization Name:NUZZI CHIROPRACTIC FAMILY & SPORTS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:A
Authorized Official - Last Name:NUZZI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-447-2570
Mailing Address - Street 1:12 GOFFLE RD
Mailing Address - Street 2:
Mailing Address - City:MIDLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07432-1815
Mailing Address - Country:US
Mailing Address - Phone:201-447-2570
Mailing Address - Fax:201-447-4206
Practice Address - Street 1:12 GOFFLE RD
Practice Address - Street 2:
Practice Address - City:MIDLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07432-1815
Practice Address - Country:US
Practice Address - Phone:201-447-2570
Practice Address - Fax:201-447-4206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00433800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5501105Medicaid
NJU42670Medicare UPIN
NJ5501105Medicaid