Provider Demographics
NPI:1932459922
Name:CHIROPRACTIC INTEGRATED SERVICES
Entity Type:Organization
Organization Name:CHIROPRACTIC INTEGRATED SERVICES
Other - Org Name:PATERSON ACUPUNCTURE & CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:YANAL
Authorized Official - Middle Name:
Authorized Official - Last Name:KAZAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-942-1212
Mailing Address - Street 1:470 CHAMBERLAIN AVE
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07522-1031
Mailing Address - Country:US
Mailing Address - Phone:973-942-1212
Mailing Address - Fax:973-942-0523
Practice Address - Street 1:470 CHAMBERLAIN AVE
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07522-1031
Practice Address - Country:US
Practice Address - Phone:973-942-1212
Practice Address - Fax:973-942-0523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-17
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2333261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service