Provider Demographics
NPI:1609813013
Name:SOMERSET COUNTY CHIROPRACTIC CENTER, P.A.
Entity Type:Organization
Organization Name:SOMERSET COUNTY CHIROPRACTIC CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:GOLDING
Authorized Official - Suffix:
Authorized Official - Credentials:DC,CA
Authorized Official - Phone:908-526-5868
Mailing Address - Street 1:373 E MAIN ST
Mailing Address - Street 2:SUITE 10
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-3143
Mailing Address - Country:US
Mailing Address - Phone:908-526-5868
Mailing Address - Fax:908-253-9826
Practice Address - Street 1:373 E MAIN ST
Practice Address - Street 2:SUITE 10
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-3143
Practice Address - Country:US
Practice Address - Phone:908-526-5868
Practice Address - Fax:908-253-9826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0108544000OtherAMERIHEALTH
NJ0076819OtherAETNA
NJ123577Medicare PIN
NJ0076819OtherAETNA