Provider Demographics
NPI:1891901617
Name:HEALTH CHIROPRACTIC REHAB CENTER LLC
Entity Type:Organization
Organization Name:HEALTH CHIROPRACTIC REHAB CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:R
Authorized Official - Last Name:ZABLOW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:973-677-2552
Mailing Address - Street 1:280 SOUTH HARRISON ST
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07018
Mailing Address - Country:US
Mailing Address - Phone:973-677-2552
Mailing Address - Fax:973-673-0477
Practice Address - Street 1:280 SOUTH HARRISON ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018
Practice Address - Country:US
Practice Address - Phone:973-677-2552
Practice Address - Fax:973-673-0477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00166800111N00000X
NJ40QA00712400261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Not Answered261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy