Provider Demographics
NPI:1821115965
Name:KHALAF, ALBERT E (DC)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:E
Last Name:KHALAF
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:266 HARRISTOWN RD
Mailing Address - Street 2:STE 304
Mailing Address - City:GLEN ROCK
Mailing Address - State:NJ
Mailing Address - Zip Code:07452-3321
Mailing Address - Country:US
Mailing Address - Phone:201-797-7373
Mailing Address - Fax:201-797-1055
Practice Address - Street 1:14-25 PLAZA RD
Practice Address - Street 2:SUITE S-2-4
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-3546
Practice Address - Country:US
Practice Address - Phone:201-797-7373
Practice Address - Fax:201-797-1055
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00630100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP3599514OtherOXFORD ID
NJV01358Medicare UPIN
NJP3599514OtherOXFORD ID