Provider Demographics
NPI:1831572726
Name:FIRST CARE CHIROPRACTIC
Entity type:Organization
Organization Name:FIRST CARE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KONSTANTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:FOTIOU
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:848-203-3280
Mailing Address - Street 1:274 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:PERTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08861-4406
Mailing Address - Country:US
Mailing Address - Phone:848-203-3280
Mailing Address - Fax:
Practice Address - Street 1:274 HIGH ST
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-4406
Practice Address - Country:US
Practice Address - Phone:848-203-3280
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-09
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00482700261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care