Provider Demographics
NPI:1568927846
Name:NJ HEALTH & INJURY SOLUTION, LLC
Entity Type:Organization
Organization Name:NJ HEALTH & INJURY SOLUTION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:ENRIQUE
Authorized Official - Last Name:DE LA TORRE
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:973-942-0220
Mailing Address - Street 1:54 LEWIS PL
Mailing Address - Street 2:
Mailing Address - City:TOTOWA
Mailing Address - State:NJ
Mailing Address - Zip Code:07512-2648
Mailing Address - Country:US
Mailing Address - Phone:973-942-0220
Mailing Address - Fax:973-942-0222
Practice Address - Street 1:442 UNION BLVD
Practice Address - Street 2:STORE FRONT
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07512
Practice Address - Country:US
Practice Address - Phone:973-942-0220
Practice Address - Fax:973-942-0222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1982987293OtherHORIZON BCBS