Provider Demographics
NPI:1447595939
Name:DEVI CHIROPRACTIC AND REHAB PC
Entity Type:Organization
Organization Name:DEVI CHIROPRACTIC AND REHAB PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHASHI
Authorized Official - Middle Name:
Authorized Official - Last Name:VISHAKANTA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:908-989-0989
Mailing Address - Street 1:2333 MORRIS AVE
Mailing Address - Street 2:#B210
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-5714
Mailing Address - Country:US
Mailing Address - Phone:908-989-0989
Mailing Address - Fax:908-688-2859
Practice Address - Street 1:2333 MORRIS AVE
Practice Address - Street 2:#B210
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-5714
Practice Address - Country:US
Practice Address - Phone:908-989-0989
Practice Address - Fax:908-688-2859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-10
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00625900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty