Provider Demographics
NPI:1811933922
Name:TAVARES, CHRISTOPHER F (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:F
Last Name:TAVARES
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 1:233 MIDDLE RD
Mailing Address - Street 2:STE 3
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-1957
Mailing Address - Country:US
Mailing Address - Phone:732-226-5552
Mailing Address - Fax:
Practice Address - Street 1:233 MIDDLE RD
Practice Address - Street 2:STE 3
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-1957
Practice Address - Country:US
Practice Address - Phone:732-226-5552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-20
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00644200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor