Provider Demographics
NPI:1710219654
Name:CHIROPRACTIC AND REHAB EXERCISE CENTER OF SOUTH JERSEY, AC, L.L.C
Entity Type:Organization
Organization Name:CHIROPRACTIC AND REHAB EXERCISE CENTER OF SOUTH JERSEY, AC, L.L.C
Other - Org Name:CARECENTER AC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:APITCHED
Authorized Official - Last Name:ALBERTI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:609-922-2456
Mailing Address - Street 1:4712 VENTNOR AVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08401-5654
Mailing Address - Country:US
Mailing Address - Phone:609-344-3123
Mailing Address - Fax:
Practice Address - Street 1:4712 VENTNOR AVE
Practice Address - Street 2:
Practice Address - City:ATLANTIC CITY
Practice Address - State:NJ
Practice Address - Zip Code:08401-5654
Practice Address - Country:US
Practice Address - Phone:609-344-3123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC005068111N00000X
NJAHL2812927133V00000X
NJ25MZ00032700171100000X
NJ40QA00696200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU68884Medicare UPIN