Provider Demographics
NPI:1376852798
Name:PASSAIC FAMILY CHIROPRACTIC, PC
Entity type:Organization
Organization Name:PASSAIC FAMILY CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ADDESA
Authorized Official - Suffix:
Authorized Official - Credentials:APN, DC
Authorized Official - Phone:908-456-0060
Mailing Address - Street 1:647 MAIN AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-4962
Mailing Address - Country:US
Mailing Address - Phone:973-778-2300
Mailing Address - Fax:973-778-2311
Practice Address - Street 1:647 MAIN AVE STE 202
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-4962
Practice Address - Country:US
Practice Address - Phone:973-778-2300
Practice Address - Fax:973-778-2311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-04
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty