Provider Demographics
NPI:1184085607
Name:SILK CITY CHIROPRACTIC, PC
Entity type:Organization
Organization Name:SILK CITY CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:STASIC
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:973-881-7200
Mailing Address - Street 1:714 BROADWAY
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07514-3402
Mailing Address - Country:US
Mailing Address - Phone:973-881-7200
Mailing Address - Fax:973-881-7207
Practice Address - Street 1:714 BROADWAY
Practice Address - Street 2:SUITE 1
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07514-3402
Practice Address - Country:US
Practice Address - Phone:973-881-7200
Practice Address - Fax:973-881-7207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-10
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00562300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty