Provider Demographics
NPI:1013232784
Name:KYLE R. EOPECHINO, LLC.
Entity Type:Organization
Organization Name:KYLE R. EOPECHINO, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:EOPECHINO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:973-777-2822
Mailing Address - Street 1:50 MOUNT PROSPECT AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-1900
Mailing Address - Country:US
Mailing Address - Phone:973-777-2822
Mailing Address - Fax:973-472-1420
Practice Address - Street 1:50 MOUNT PROSPECT AVENUE
Practice Address - Street 2:SUITE 205
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013
Practice Address - Country:US
Practice Address - Phone:973-777-2822
Practice Address - Fax:973-472-1420
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KYLE R. EOPECHINO, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-04-06
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00639200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty