Provider Demographics
NPI:1356410906
Name:PLASKER, JORDAN E (DC)
Entity type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:E
Last Name:PLASKER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:399 DARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-1306
Mailing Address - Country:US
Mailing Address - Phone:201-505-9355
Mailing Address - Fax:201-505-1711
Practice Address - Street 1:25 PHILIPS PKWY
Practice Address - Street 2:SUITE 102
Practice Address - City:MONTVALE
Practice Address - State:NJ
Practice Address - Zip Code:07645-1810
Practice Address - Country:US
Practice Address - Phone:201-505-9355
Practice Address - Fax:201-505-1711
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00585600111N00000X
NYX05667-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ095434UQDMedicare PIN
NJT81250Medicare UPIN