Princeton Chiropractic and Sports Rehab, LLC

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

38MC00374900 Issued in NJ

Legal business name

PRINCETON CHIROPRACTIC AND SPORTS REHAB, LLC

Practice address

601 Ewing St Ste C3
Princeton, NJ 08540-2756

Phone

(609) 921-1705

Fax

(609) 921-8871

NPI assigned

Jan 8, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Edward Sofo, D.C.NPI 1922014729

Title

Owner

Phone

(609) 921-1705

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edward Vincent Sofo, D.C., C.C.S.P.

  • Chiropractor
  • Martinsville, NJ
  • NPI 1922014729

  Sports Physician

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1420675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420675200000",
    "number": "1265820559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 EWING ST STE C3",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085402756",
            "telephone_number": "609-921-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 EWING ST STE C3",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085402756",
            "telephone_number": "609-921-1705",
            "fax_number": "609-921-8871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCETON CHIROPRACTIC AND SPORTS REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-08",
        "last_updated": "2015-01-08",
        "status": "A",
        "authorized_official_last_name": "SOFO",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-921-1705",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "NJ",
            "license": "38MC00374900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Princeton Center for Therapy and Assessment, LLC
• Princeton Child Development Institute
• Princeton Child Development Institute
• Princeton Child Development Institute
• Princeton Child Development Institute
• Princeton Chiropractic Center, L.L.C.
• Princeton Day Spa, Inc
• Princeton Dermatology Associates II LLC
• Princeton Dermatology Associates PC
• Princeton Ear Nose & Throat PC

• Sports Physician Chiropractor in Princeton, NJ
• Providers in Princeton, NJ by specialty
• Sports Physician Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.