Provider Demographics
NPI:1932395837
Name:RIVANO CHIROPRACTIC HEALTH CENTER LLC
Entity Type:Organization
Organization Name:RIVANO CHIROPRACTIC HEALTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVANO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:973-845-6282
Mailing Address - Street 1:135 COLUMBIA TURNPIKE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-2189
Mailing Address - Country:US
Mailing Address - Phone:973-845-6282
Mailing Address - Fax:973-845-6283
Practice Address - Street 1:135 COLUMBIA TPKE
Practice Address - Street 2:SUITE 301
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-2189
Practice Address - Country:US
Practice Address - Phone:973-845-6282
Practice Address - Fax:973-845-6283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00657000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========OtherTAX IDENTIFICATION