Provider Demographics
NPI:1982843082
Name:DANIEL FAMILY CHIORPRACTIC PC
Entity Type:Organization
Organization Name:DANIEL FAMILY CHIORPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:DANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-934-1166
Mailing Address - Street 1:65 N FRANKLIN TPKE
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-2005
Mailing Address - Country:US
Mailing Address - Phone:201-934-1166
Mailing Address - Fax:
Practice Address - Street 1:65 N FRANKLIN TPKE
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-2005
Practice Address - Country:US
Practice Address - Phone:201-934-1166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-12
Last Update Date:2009-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00220400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJT45025Medicare UPIN
NJ444753Medicare PIN