Provider Demographics
NPI:1598189466
Name:GOLDS CHIROPRACTIC & WELLNESS CENTER PC
Entity Type:Organization
Organization Name:GOLDS CHIROPRACTIC & WELLNESS CENTER PC
Other - Org Name:ELITE PHYSICAL MEDICINE & REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING REPRESENTATIVE
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HILDERLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-683-3855
Mailing Address - Street 1:50 ROUTE 10 W
Mailing Address - Street 2:
Mailing Address - City:WHIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07981-2123
Mailing Address - Country:US
Mailing Address - Phone:973-884-3400
Mailing Address - Fax:
Practice Address - Street 1:279 ROUTE 46
Practice Address - Street 2:
Practice Address - City:ROCKAWAY
Practice Address - State:NJ
Practice Address - Zip Code:07866-3851
Practice Address - Country:US
Practice Address - Phone:973-784-4550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-12
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ111N00000X
171100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty