Provider Demographics
NPI:1144819160
Name:CNC CHIROPRACTIC P.C
Entity type:Organization
Organization Name:CNC CHIROPRACTIC P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MINJAE
Authorized Official - Middle Name:
Authorized Official - Last Name:YOO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-566-5396
Mailing Address - Street 1:248 EUCLID AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07660-1538
Mailing Address - Country:US
Mailing Address - Phone:201-566-5396
Mailing Address - Fax:
Practice Address - Street 1:570 PIERMONT RD STE A7
Practice Address - Street 2:
Practice Address - City:CLOSTER
Practice Address - State:NJ
Practice Address - Zip Code:07624-3100
Practice Address - Country:US
Practice Address - Phone:201-564-7888
Practice Address - Fax:201-479-0312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty