NPIMap

Organization Active NPI

Park Place Chiropractic and Rehabilitation

  • Rehabilitation Chiropractor
  • Newark, NJ
National Provider Identifier
1285079590
Registry record updated May 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
MC03260 Issued in NJ
Legal business name
PARK PLACE CHIROPRACTIC AND REHABILITATION
Practice address
17 Academy St
Newark, NJ 07102-2923
Phone
(973) 824-2225
Fax
(973) 824-5454
NPI assigned
May 1, 2013
Last updated
May 1, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2013

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

Authorized official

Name
Dr. Gary Stepan Bozian, DCNPI 1104260165
Title
President
Phone
(973) 824-2225

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 38MCOO326000 NJ
Rehabilitation Chiropractor 111NR0400X MC03260 NJ Primary

Addresses

Primary practice location

17 Academy St
Newark, NJ 07102-2923

Mailing address

17 Academy St
Newark, NJ 07102-2923
Phone (973) 824-2225

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1367366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367366400000",
    "number": "1285079590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 ACADEMY ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071022923",
            "telephone_number": "973-824-2225",
            "fax_number": "973-824-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 ACADEMY ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071022923",
            "telephone_number": "973-824-2225",
            "fax_number": "973-824-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK PLACE CHIROPRACTIC AND REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-01",
        "last_updated": "2013-05-01",
        "status": "A",
        "authorized_official_last_name": "BOZIAN",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "STEPAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-824-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NJ",
            "license": "38MCOO326000",
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "NJ",
            "license": "MC03260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2013; 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.