Provider Demographics
NPI:1770847394
Name:AVERION, ERTON JOSEPH CALINGASAN (DC)
Entity Type:Individual
Prefix:DR
First Name:ERTON JOSEPH
Middle Name:CALINGASAN
Last Name:AVERION
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 JACK MARTIN BLVD
Mailing Address - Street 2:STE 101
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-7737
Mailing Address - Country:US
Mailing Address - Phone:716-400-1808
Mailing Address - Fax:
Practice Address - Street 1:41 WILSON AVE
Practice Address - Street 2:1C
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105-3214
Practice Address - Country:US
Practice Address - Phone:973-344-4848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-28
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00702300111N00000X
NYX012202-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor