Active NPI
Marie Jean Destefan, DC
- Chiropractor
- Union City, NJ
National Provider Identifier
1376632406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- NJMC03606
- Practice address
- 314 48TH St
Union City, NJ 07087-5106 - Phone
- (201) 865-0300
- Fax
- (201) 865-8404
- NPI assigned
- Oct 12, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | NJMC03606 | NJ | Primary |
Addresses
Primary practice location
314 48TH St
Union City, NJ 07087-5106
Mailing address
314 48TH St
Union City, NJ 07087-5106
Phone (201) 865-0300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NJMC03606 | NJ | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277942400000",
"number": "1376632406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "314 48TH ST",
"city": "UNION CITY",
"state": "NJ",
"postal_code": "070875106",
"telephone_number": "201-865-0300",
"fax_number": "201-865-8404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "314 48TH ST",
"city": "UNION CITY",
"state": "NJ",
"postal_code": "070875106",
"telephone_number": "201-865-0300",
"fax_number": "201-865-8404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESTEFAN",
"first_name": "MARIE",
"middle_name": "JEAN",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-12",
"last_updated": "2010-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NJ",
"license": "NJMC03606",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Union City, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.