Provider Demographics
NPI:1588619381
Name:BIERSTEIN, MATICA ELANA (DC)
Entity Type:Individual
Prefix:MRS
First Name:MATICA
Middle Name:ELANA
Last Name:BIERSTEIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:MATICA
Other - Middle Name:ELANA
Other - Last Name:COHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:428 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08810-1318
Mailing Address - Country:US
Mailing Address - Phone:732-329-1300
Mailing Address - Fax:732-329-3232
Practice Address - Street 1:428 RIDGE RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:NJ
Practice Address - Zip Code:08810-1318
Practice Address - Country:US
Practice Address - Phone:732-329-1300
Practice Address - Fax:732-329-3232
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC03438111N00000X
FLCH5717111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
938420OtherHEALTHNET ID
NJ3412504Medicaid
602074OtherAETNA PROVIDER ID
0115919000OtherAMERIHEALTH ID
P413296OtherOXFORD ID
938420OtherHEALTHNET ID
T45712Medicare UPIN