Provider Demographics
NPI:1972519254
Name:WEBER, JASON (DC, DACRB)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:
Last Name:WEBER
Suffix:
Gender:M
Credentials:DC, DACRB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 MARKET ST STE 1
Mailing Address - Street 2:
Mailing Address - City:SADDLE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07663-5932
Mailing Address - Country:US
Mailing Address - Phone:201-843-8300
Mailing Address - Fax:201-843-7833
Practice Address - Street 1:480 MARKET ST STE 1
Practice Address - Street 2:
Practice Address - City:SADDLE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07663-5932
Practice Address - Country:US
Practice Address - Phone:201-843-8300
Practice Address - Fax:201-843-7833
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC005732111N00000X, 111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ043840Medicare ID - Type Unspecified
NJU80706Medicare UPIN