Provider Demographics
NPI:1912884537
Name:PANTOCRATOR FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:PANTOCRATOR FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:FEBRONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:NESSIM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-338-8479
Mailing Address - Street 1:12 S HOLMDEL RD
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-2130
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12 S HOLMDEL RD
Practice Address - Street 2:
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-2130
Practice Address - Country:US
Practice Address - Phone:732-338-8479
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty