Provider Demographics
NPI:1831221084
Name:BRANFORD CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:BRANFORD CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:FUNICIELLO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:973-643-3234
Mailing Address - Street 1:20-24 BRANFORD PL
Mailing Address - Street 2:SUITE 805
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07102-2786
Mailing Address - Country:US
Mailing Address - Phone:973-643-3234
Mailing Address - Fax:973-643-5428
Practice Address - Street 1:20-24 BRANFORD PL
Practice Address - Street 2:SUITE 805
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-2786
Practice Address - Country:US
Practice Address - Phone:973-643-3234
Practice Address - Fax:973-643-5428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC04415111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty