Provider Demographics
NPI:1962597872
Name:YABROUDY, THOMAS (DC)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:YABROUDY
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 1:441 OVERHILL RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-1239
Mailing Address - Country:US
Mailing Address - Phone:973-743-9700
Mailing Address - Fax:
Practice Address - Street 1:206 BELLEVILLE AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-3589
Practice Address - Country:US
Practice Address - Phone:973-743-9700
Practice Address - Fax:973-743-9730
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00521100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor