Provider Demographics
NPI:1679913107
Name:OBEBE MEMRIAL CHIROPRACTIC CENTER, P.C.
Entity Type:Organization
Organization Name:OBEBE MEMRIAL CHIROPRACTIC CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIANA
Authorized Official - Middle Name:OLANREWAJU
Authorized Official - Last Name:OBEBE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:973-372-4747
Mailing Address - Street 1:989 SANFORD AVE
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07111-1444
Mailing Address - Country:US
Mailing Address - Phone:973-372-4747
Mailing Address - Fax:973-372-4116
Practice Address - Street 1:989 SANFORD AVE
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-1444
Practice Address - Country:US
Practice Address - Phone:973-372-4747
Practice Address - Fax:973-372-4116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-28
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty