Provider Demographics
NPI:1497193130
Name:FARIS CHIROPRACTIC
Entity Type:Organization
Organization Name:FARIS CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KARIM
Authorized Official - Middle Name:HABIB
Authorized Official - Last Name:FARIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC, MS
Authorized Official - Phone:973-879-4074
Mailing Address - Street 1:50 W LINDSLEY RD
Mailing Address - Street 2:UNIT #3
Mailing Address - City:CEDAR GROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:07009-1053
Mailing Address - Country:US
Mailing Address - Phone:973-879-4074
Mailing Address - Fax:
Practice Address - Street 1:1425 POMPTON AVE STE 2-1A
Practice Address - Street 2:
Practice Address - City:CEDAR GROVE
Practice Address - State:NJ
Practice Address - Zip Code:07009-1074
Practice Address - Country:US
Practice Address - Phone:973-237-1221
Practice Address - Fax:973-237-0884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-04
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00693300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty