Provider Demographics
NPI:1942379037
Name:HIRAS, EMANUEL M (DC, CA)
Entity Type:Individual
Prefix:DR
First Name:EMANUEL
Middle Name:M
Last Name:HIRAS
Suffix:
Gender:M
Credentials:DC, CA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BETHANY RD
Mailing Address - Street 2:BUILDING 1 SUITE 9
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-1663
Mailing Address - Country:US
Mailing Address - Phone:732-264-5124
Mailing Address - Fax:732-264-5126
Practice Address - Street 1:1 BETHANY RD
Practice Address - Street 2:BUILDING 1 SUITE 9
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-1663
Practice Address - Country:US
Practice Address - Phone:732-264-5124
Practice Address - Fax:732-264-5126
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC04312111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU47074Medicare UPIN
NJ100327Medicare ID - Type UnspecifiedID NUMBER