Provider Demographics
NPI:1710022272
Name:DREW FAMILY CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:DREW FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:DREW
Authorized Official - Middle Name:EVAN
Authorized Official - Last Name:SPERGEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:973-533-0755
Mailing Address - Street 1:315 E NORTHFIELD RD
Mailing Address - Street 2:SUITE 3-C
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4896
Mailing Address - Country:US
Mailing Address - Phone:973-533-0755
Mailing Address - Fax:973-533-0955
Practice Address - Street 1:315 E NORTHFIELD RD
Practice Address - Street 2:SUITE 3-C
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4896
Practice Address - Country:US
Practice Address - Phone:973-533-0755
Practice Address - Fax:973-533-0955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC00564400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU86624Medicare UPIN
NJ094808Medicare PIN