Provider Demographics
NPI:1932499258
Name:PARAMOUNT CHIROPRACTIC & REHABILITATION
Entity Type:Organization
Organization Name:PARAMOUNT CHIROPRACTIC & REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:NIERVA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-638-5109
Mailing Address - Street 1:330 STATE ST
Mailing Address - Street 2:
Mailing Address - City:PERTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08861-4119
Mailing Address - Country:US
Mailing Address - Phone:732-638-5109
Mailing Address - Fax:
Practice Address - Street 1:330 STATE ST
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-4119
Practice Address - Country:US
Practice Address - Phone:732-638-5109
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-08
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00607900261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service