Provider Demographics
NPI:1629004338
Name:ALLENTOWN CHIROPRACTIC GROUP
Entity Type:Organization
Organization Name:ALLENTOWN CHIROPRACTIC GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:SARACEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:609-259-3700
Mailing Address - Street 1:23 S MAIN ST
Mailing Address - Street 2:P.O. BOX 626
Mailing Address - City:ALLENTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08501-1615
Mailing Address - Country:US
Mailing Address - Phone:609-259-3700
Mailing Address - Fax:609-259-3700
Practice Address - Street 1:23 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08501-1615
Practice Address - Country:US
Practice Address - Phone:609-259-3700
Practice Address - Fax:609-259-3700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00458100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ021347Medicare ID - Type Unspecified
NJU72714Medicare UPIN