Provider Demographics
NPI:1649600065
Name:INVICTUS FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:INVICTUS FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ELEUTERI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:973-627-0475
Mailing Address - Street 1:276 E MAIN ST
Mailing Address - Street 2:11
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-2646
Mailing Address - Country:US
Mailing Address - Phone:973-627-0475
Mailing Address - Fax:
Practice Address - Street 1:276 E MAIN ST
Practice Address - Street 2:11
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-2646
Practice Address - Country:US
Practice Address - Phone:973-627-0475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-21
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00690900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1710286893OtherNATIONAL PROVIDER IDENTIFIER