Provider Demographics
NPI:1982903977
Name:BAJZATH REHABILITATION FACILITY PC
Entity Type:Organization
Organization Name:BAJZATH REHABILITATION FACILITY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:BAJZATH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-797-2225
Mailing Address - Street 1:17-15 MAPLE AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-1552
Mailing Address - Country:US
Mailing Address - Phone:201-797-2225
Mailing Address - Fax:201-797-2221
Practice Address - Street 1:17-15 MAPLE AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-1552
Practice Address - Country:US
Practice Address - Phone:201-797-2225
Practice Address - Fax:201-797-2221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-16
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty