Provider Demographics
NPI:1528347499
Name:ABOVE AND BEYOND CHIROPRACTIC CENTERS LLC
Entity type:Organization
Organization Name:ABOVE AND BEYOND CHIROPRACTIC CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:A
Authorized Official - Last Name:KOBRIN AL GHURAIBAWI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:203-799-7100
Mailing Address - Street 1:109 BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CT
Mailing Address - Zip Code:06477-3235
Mailing Address - Country:US
Mailing Address - Phone:203-799-7100
Mailing Address - Fax:203-298-4601
Practice Address - Street 1:109 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CT
Practice Address - Zip Code:06477-3235
Practice Address - Country:US
Practice Address - Phone:203-799-7100
Practice Address - Fax:203-298-4601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-10
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001690111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT350001536Medicare UPIN
CTX5X6K1Medicare PIN