Provider Demographics
NPI:1144365511
Name:CARSKADDAN CHIROPRACTIC OF TOMS RIVER, P.C.
Entity type:Organization
Organization Name:CARSKADDAN CHIROPRACTIC OF TOMS RIVER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:CARSKADDAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-255-8335
Mailing Address - Street 1:1901 HOOPER AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-1600
Mailing Address - Country:US
Mailing Address - Phone:732-255-8335
Mailing Address - Fax:732-255-8261
Practice Address - Street 1:1901 HOOPER AVE
Practice Address - Street 2:SUITE A
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-1600
Practice Address - Country:US
Practice Address - Phone:732-255-8335
Practice Address - Fax:732-255-8261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00414800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ013928Medicare ID - Type Unspecified