BERGEN SPINE CENTER, LLC (NPI# 1750509402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750509402 |
| Entity Type | Organization |
| Organization Name | BERGEN SPINE CENTER, LLC |
| Practice Address |
323 Bergen Boulevard Fairview NJ 07022-1334 |
| Practice Telephone | 2019459993 |
| Practice Fax Number | 2019458873 |
| Mailing Telephone | 2019459993 |
| Mailing Fax Number | 2019458873 |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JOSEPH STEPHAN (DOCTOR OF CHIROPRACTIC) |
| Authorized Official Telephone | 2019459993 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 38MC00653900 | NJ | Chiropractic Providers |
| Street Address |
323 BERGEN BOULEVARD |
| City | FAIRVIEW |
| State | NJ |
| Zip Code | 07022-1334 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043393085 | Advanced Physical Medicine Center, LLC | Clinic/Center | 222 Bergen Blvd, Ste 8, Fairview, NJ 07022 | 2006-10-23 |
| 1932125952 | Open Mri of Fairview | Clinic/Center | 178 Bergen Blvd, Fairview, NJ 07022 | 2006-07-14 |
| 1104902212 | Marianne Encarnacion | Physical Therapist | 222 Bergen Blvd, Ste 8, Fairview, NJ 07022 | 2006-10-31 |
| 1831275940 | David Berk | Chiropractor | 222 Bergen Blvd, Ste 8, Fairview, NJ 07022 | 2006-10-31 |
| 1548343585 | Michael Arber | Chiropractor | 222 Bergen Blvd, Ste 8, Fairview, NJ 07022 | 2006-10-23 |
| 1518982172 | Great Atlantic & Pacific Tea Company Inc | Pharmacy | 425 Anderson Ave, Fairview, NJ 07022-1103 | 2006-07-13 |
| 1154599421 | Evan Reinecke | Pharmacist | 425 Anderson Ave, Fairview, NJ 07022-1103 | 2008-02-20 |
| 1326216813 | Max Gruenberg | Pharmacist | 425 Anderson Ave, Fairview, NJ 07022-1103 | 2008-02-18 |
| 1356819767 | Young Sun Kim | Acupuncturist | 452 N 8th St Unit B, Fairview, NJ 07022-1106 | 2018-11-05 |
| 1780077875 | Mina Garas | Pharmacist | 374 Park Ave, Fairview, NJ 07022-1114 | 2015-03-12 |
| Find all providers in zip 07022 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558732123 | Greenhead Diagnostics, LLC | Chiropractor | 637 Merlot Ct, Fairview, TX 75069-1521 | 2015-10-08 |
| 1619135886 | Lenore Lynn Wolfe | Chiropractor | 29945 Palm Rd, Fairview, MO 64842-7107 | 2008-05-23 |
| 1790950228 | Springwater Chiropractic Inc | Chiropractor | 1659 Ne Market Drive, Fairview, OR 97024-3867 | 2008-04-25 |
| 1558548024 | Lee W. Ligon, D.c., P.C. | Chiropractor | 990 State Highway 5, Suite 103, Fairview, TX 75069-9461 | 2008-01-28 |
| 1295954030 | Brian Edward Kiczek | Chiropractor | 216 Anderson Ave, Rear Office, Fairview, NJ 07022-1468 | 2007-04-24 |
| 1275756181 | Lee Wilson Ligon | Chiropractor | 990 S State Highway 5, Suite 103, Fairview, TX 75069-9461 | 2007-04-10 |
| 1891815957 | Robert Craig Stassi I | Chiropractor | 1606 Ne 223rd Ave, Fairview, OR 97024-2662 | 2007-03-30 |
| 1699816538 | Brian M Wraith | Chiropractor | 323 Bergen Blvd, Suite 3, Fairview, NJ 07022-1334 | 2007-02-12 |
| 1033145842 | Cherie A Mckenzie | Chiropractor | 1554 N Abbe Rd, Fairview, MI 48621-8719 | 2006-06-23 |
| 1255303657 | Edward G Reilly | Chiropractor | 2 Fairview Hills Dr, Fairview, NC 28730-9777 | 2006-02-02 |
| Find all providers in FAIRVIEW | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.