Provider Demographics
NPI:1760073415
Name:CHIROCENTER PA
Entity Type:Organization
Organization Name:CHIROCENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ZBIGNIEW
Authorized Official - Middle Name:STANLEY
Authorized Official - Last Name:DUBIJ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:973-470-9900
Mailing Address - Street 1:136 E CRESCENT AVE
Mailing Address - Street 2:
Mailing Address - City:MAHWAH
Mailing Address - State:NJ
Mailing Address - Zip Code:07430-1566
Mailing Address - Country:US
Mailing Address - Phone:973-470-9900
Mailing Address - Fax:
Practice Address - Street 1:136 E CRESCENT AVE
Practice Address - Street 2:
Practice Address - City:MAHWAH
Practice Address - State:NJ
Practice Address - Zip Code:07430-1566
Practice Address - Country:US
Practice Address - Phone:973-470-9000
Practice Address - Fax:973-470-0309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-26
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty