Provider Demographics
NPI:1659354249
Name:PENNINGTON FAMILY WELLNESS LLC
Entity Type:Organization
Organization Name:PENNINGTON FAMILY WELLNESS LLC
Other - Org Name:PENNINGTON FAMILY CHIROPRACTIC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARYN
Authorized Official - Middle Name:
Authorized Official - Last Name:GABAI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:609-737-3737
Mailing Address - Street 1:23 ROUTE 31 N STE 26B
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-1600
Mailing Address - Country:US
Mailing Address - Phone:609-737-3737
Mailing Address - Fax:609-737-1124
Practice Address - Street 1:23 ROUTE 31 N
Practice Address - Street 2:SUITE B26
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-0853
Practice Address - Country:US
Practice Address - Phone:609-737-3737
Practice Address - Fax:609-737-1124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-28
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00202000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4406543OtherAETNA
NJ030497984OtherBLUE CROSS/BLUE SHIELD
NJ087865Medicare ID - Type Unspecified