Provider Demographics
NPI:1952351413
Name:STABILE, NICHOLAS (DC)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:
Last Name:STABILE
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 1:187 WASHINGTON AVE
Mailing Address - Street 2:STE 2B
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-1995
Mailing Address - Country:US
Mailing Address - Phone:973-477-0033
Mailing Address - Fax:
Practice Address - Street 1:265 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-2712
Practice Address - Country:US
Practice Address - Phone:973-661-0500
Practice Address - Fax:973-661-0562
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-12
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC005796111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ066767Medicare ID - Type Unspecified