Provider Demographics
NPI:1467496117
Name:EOPECHINO, KYLE R (DC)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:R
Last Name:EOPECHINO
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 1:50 MOUNT PROSPECT AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-1900
Mailing Address - Country:US
Mailing Address - Phone:973-777-2822
Mailing Address - Fax:973-472-1420
Practice Address - Street 1:50 MOUNT PROSPECT AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-1900
Practice Address - Country:US
Practice Address - Phone:973-777-2822
Practice Address - Fax:973-472-1420
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00639200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor