Provider Demographics
NPI:1639242704
Name:DR JORGE RINCON CHIROPRACTIC CENTER LLC
Entity Type:Organization
Organization Name:DR JORGE RINCON CHIROPRACTIC CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:ENRIQUE
Authorized Official - Last Name:RINCON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:908-884-4846
Mailing Address - Street 1:336 LOOMIS ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07206-1024
Mailing Address - Country:US
Mailing Address - Phone:908-884-4846
Mailing Address - Fax:
Practice Address - Street 1:1308 MORRIS AVE STE 201
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-3328
Practice Address - Country:US
Practice Address - Phone:908-884-4846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00583900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty