Provider Demographics
NPI:1477670669
Name:KLOORFAIN CHIROPRACTIC OFFICES, PA
Entity Type:Organization
Organization Name:KLOORFAIN CHIROPRACTIC OFFICES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KLOORFAIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-664-6300
Mailing Address - Street 1:333 OLD HOOK RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-3200
Mailing Address - Country:US
Mailing Address - Phone:201-664-6300
Mailing Address - Fax:201-664-1225
Practice Address - Street 1:333 OLD HOOK RD
Practice Address - Street 2:SUITE 102
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-3200
Practice Address - Country:US
Practice Address - Phone:201-664-6300
Practice Address - Fax:201-664-1225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ080347Medicare PIN