NPIMap

Organization Active NPI

Broadway Spine Care

  • Chiropractor
  • North Bergen, NJ
National Provider Identifier
1134440589
Registry record updated Jun 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00353600 Issued in NJ
Legal business name
BROADWAY SPINE CARE
Practice address
7711 Broadway
North Bergen, NJ 07047-5728
Phone
(201) 766-2648
Fax
(201) 766-2650
NPI assigned
Jun 21, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Jeffrey Paul Kavalin, D.C.
Title
Partner
Phone
(201) 766-2648

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 38MC00353600 NJ Primary

Addresses

Primary practice location

7711 Broadway
North Bergen, NJ 07047-5728

Mailing address

7711 Broadway
North Bergen, NJ 07047-5728
Phone (201) 766-2648

National Provider Directory

National Provider Directory

Locations

7711 Broadway
North Bergen, NJ 07047
Phone (201) 766-2648

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1277078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277078400000",
    "number": "1134440589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7711 BROADWAY",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070475728",
            "telephone_number": "201-766-2648",
            "fax_number": "201-766-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7711 BROADWAY",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070475728",
            "telephone_number": "201-766-2648",
            "fax_number": "201-766-2650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY SPINE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-21",
        "last_updated": "2010-06-21",
        "status": "A",
        "authorized_official_last_name": "KAVALIN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "201-766-2648",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00353600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Bergen, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.