Provider Demographics
NPI:1255046702
Name:CORE 44 LLC
Entity type:Organization
Organization Name:CORE 44 LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:GENCARELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:973-200-0170
Mailing Address - Street 1:PO BOX 11004
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07004-7004
Mailing Address - Country:US
Mailing Address - Phone:973-200-0170
Mailing Address - Fax:
Practice Address - Street 1:18 FURLER ST
Practice Address - Street 2:
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07512-2765
Practice Address - Country:US
Practice Address - Phone:973-200-0170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-19
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty