Provider Demographics
NPI:1700418449
Name:KIRSTEIN, GAGE (DC)
Entity Type:Individual
Prefix:DR
First Name:GAGE
Middle Name:
Last Name:KIRSTEIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1161 MORTON AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSGROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:08318-4059
Mailing Address - Country:US
Mailing Address - Phone:856-332-8112
Mailing Address - Fax:
Practice Address - Street 1:630 S BREWSTER RD STE B2
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08361-7801
Practice Address - Country:US
Practice Address - Phone:856-692-9299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-11
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00768900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor