Provider Demographics
NPI:1750457917
Name:RARITAN VALLEY CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:RARITAN VALLEY CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:J
Authorized Official - Last Name:MAYER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-985-0700
Mailing Address - Street 1:1716 HIGHWAY
Mailing Address - Street 2:#27
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-3449
Mailing Address - Country:US
Mailing Address - Phone:732-985-0700
Mailing Address - Fax:732-985-0701
Practice Address - Street 1:1716 HIGHWAY
Practice Address - Street 2:#27
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-3449
Practice Address - Country:US
Practice Address - Phone:732-985-0700
Practice Address - Fax:732-985-0701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty