Provider Demographics
NPI:1861615916
Name:FAMILY CHIROPRACTORS OF MONTCLAIR LLC
Entity type:Organization
Organization Name:FAMILY CHIROPRACTORS OF MONTCLAIR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MIZRAJI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:973-783-5666
Mailing Address - Street 1:39 WATCHUNG PLZ
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-4117
Mailing Address - Country:US
Mailing Address - Phone:973-783-5666
Mailing Address - Fax:973-783-7209
Practice Address - Street 1:39 WATCHUNG PLZ
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-4117
Practice Address - Country:US
Practice Address - Phone:973-783-5666
Practice Address - Fax:973-783-7209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00367800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty