Provider Demographics
NPI:1801027321
Name:MEIMARIS SPORTS CHIROPRACTIC
Entity Type:Organization
Organization Name:MEIMARIS SPORTS CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DEMETRI
Authorized Official - Middle Name:G
Authorized Official - Last Name:MEIMARIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-487-3131
Mailing Address - Street 1:31 MERCER ST
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-5617
Mailing Address - Country:US
Mailing Address - Phone:201-487-3131
Mailing Address - Fax:201-487-3103
Practice Address - Street 1:31 MERCER ST
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-5617
Practice Address - Country:US
Practice Address - Phone:201-487-3131
Practice Address - Fax:201-487-3103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-31
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00278700261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJT72989Medicare UPIN
NJ456717Medicare PIN