Provider Demographics
NPI:1518175207
Name:SCUDDER CHIROPRACTIC & WELLNESS CENTERS, PC
Entity Type:Organization
Organization Name:SCUDDER CHIROPRACTIC & WELLNESS CENTERS, PC
Other - Org Name:EASTAMPTON CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:JONATHAN
Authorized Official - Last Name:SCUDDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:609-267-8040
Mailing Address - Street 1:2 NORTHUMBERLAND DR
Mailing Address - Street 2:
Mailing Address - City:EASTAMPTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-3212
Mailing Address - Country:US
Mailing Address - Phone:609-267-8040
Mailing Address - Fax:609-914-0231
Practice Address - Street 1:2 NORTHUMBERLAND DR
Practice Address - Street 2:
Practice Address - City:EASTAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08060-3212
Practice Address - Country:US
Practice Address - Phone:609-267-8040
Practice Address - Fax:609-914-0231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00439400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5005557OtherAETNA
NJU35553Medicare UPIN