Provider Demographics
NPI:1104329374
Name:EVEREST CHIROPRACTIC PC
Entity type:Organization
Organization Name:EVEREST CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NADEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:908-505-0992
Mailing Address - Street 1:200 SHEFFIELD ST STE 303
Mailing Address - Street 2:
Mailing Address - City:MOUNTAINSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07092-2314
Mailing Address - Country:US
Mailing Address - Phone:908-505-0992
Mailing Address - Fax:646-626-6370
Practice Address - Street 1:200 SHEFFIELD ST STE 303
Practice Address - Street 2:
Practice Address - City:MOUNTAINSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07092-2314
Practice Address - Country:US
Practice Address - Phone:908-505-0992
Practice Address - Fax:646-626-6370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-14
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00731300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty