Provider Demographics
NPI:1922763606
Name:CORE ZONE INTEGRATED MEDICAL AND WELLNESS
Entity Type:Organization
Organization Name:CORE ZONE INTEGRATED MEDICAL AND WELLNESS
Other - Org Name:CORE ZONE INTEGRATED MEDICAL AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:CORREGANO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-707-4677
Mailing Address - Street 1:3996 COUNTY ROAD 516 STE 110
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-7017
Mailing Address - Country:US
Mailing Address - Phone:732-707-4677
Mailing Address - Fax:732-402-8300
Practice Address - Street 1:3996 COUNTY RD 516 MATAWAN, NJ
Practice Address - Street 2:SUITE 110
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747
Practice Address - Country:US
Practice Address - Phone:732-935-1000
Practice Address - Fax:732-935-9100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-08
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ38MC00550400OtherSTATE LICENSE