Provider Demographics
NPI:1851736581
Name:MORALES FAMILY CHIROPRACTIC PA
Entity Type:Organization
Organization Name:MORALES FAMILY CHIROPRACTIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ELVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:973-249-7400
Mailing Address - Street 1:192 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-6205
Mailing Address - Country:US
Mailing Address - Phone:973-249-7400
Mailing Address - Fax:973-249-7403
Practice Address - Street 1:192 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-6205
Practice Address - Country:US
Practice Address - Phone:973-249-7400
Practice Address - Fax:973-249-7403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-08
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00514800302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization