Provider Demographics
NPI:1730280199
Name:MEADOWLANDS CHIROPRACTIC CENTER, P.A.
Entity Type:Organization
Organization Name:MEADOWLANDS CHIROPRACTIC CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:V
Authorized Official - Last Name:ZACCARIA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-438-2404
Mailing Address - Street 1:360 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07071-2212
Mailing Address - Country:US
Mailing Address - Phone:201-438-2404
Mailing Address - Fax:201-438-5739
Practice Address - Street 1:360 RIDGE RD
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:NJ
Practice Address - Zip Code:07071-2212
Practice Address - Country:US
Practice Address - Phone:201-438-2404
Practice Address - Fax:201-438-5739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00131700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2995603Medicaid
NJ0936093OtherAETNA
NJ1076624OtherNJ HEALTH HORIZON HMO
NJ4066261OtherCIGNA HEALTH CARE
NJ8211-161OtherGHI
NJNJ01317OtherGUARDIAN HEALTH NET
NJ460651OtherAMERIHEALTH
NJFZ0X3W0210OtherEMPIRE BLUE CROSS BLUE SH
NJ1006489OtherAMERICAN SPECIALTY HEALTH
NJP538623OtherOXFORD
NJ1076624OtherNJ HEALTH HORIZON HMO