Provider Demographics
NPI:1255545075
Name:LEVY CHIROPRACTIC FAMILY WELLNESS CENTER, LLC
Entity type:Organization
Organization Name:LEVY CHIROPRACTIC FAMILY WELLNESS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:G
Authorized Official - Last Name:LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-617-7700
Mailing Address - Street 1:14 ROUTE 520
Mailing Address - Street 2:
Mailing Address - City:ENGLISHTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-8297
Mailing Address - Country:US
Mailing Address - Phone:732-617-7700
Mailing Address - Fax:732-617-7005
Practice Address - Street 1:14 ROUTE 520
Practice Address - Street 2:
Practice Address - City:ENGLISHTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07726-8297
Practice Address - Country:US
Practice Address - Phone:732-617-7700
Practice Address - Fax:732-617-7005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU16599Medicare UPIN
NJ113670Medicare PIN