Provider Demographics
NPI:1508825837
Name:ERBECK, KATHLEEN (DC)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:ERBECK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 COLD HILL RD S
Mailing Address - Street 2:BLDG 18
Mailing Address - City:MENDHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07945-3230
Mailing Address - Country:US
Mailing Address - Phone:973-543-7028
Mailing Address - Fax:973-543-7028
Practice Address - Street 1:5 COLD HILL RD S
Practice Address - Street 2:BLDG 18
Practice Address - City:MENDHAM
Practice Address - State:NJ
Practice Address - Zip Code:07945-1546
Practice Address - Country:US
Practice Address - Phone:973-543-7028
Practice Address - Fax:973-543-7028
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00221400111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ052111Medicare UPIN