Eric Roy Von Der Lieth

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

38MC00496900 Issued in NJ

Practice address

43 Hawthorne Ave
Park Ridge, NJ 07656-1249

Phone

(201) 505-1600

NPI assigned

Jul 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Body Shop Physical Therapy and Wellness LLC

  • Physical Therapist
  • Hackensack, NJ
  • NPI 1326870114

  Chiropractor

  NPD

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386674752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 HAWTHORNE AVE",
            "city": "PARK RIDGE",
            "state": "NJ",
            "postal_code": "076561249",
            "telephone_number": "201-505-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 HAWTHORNE AVE",
            "city": "PARK RIDGE",
            "state": "NJ",
            "postal_code": "076561249",
            "telephone_number": "201-505-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VON DER LIETH",
        "first_name": "ERIC",
        "middle_name": "ROY",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00496900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaime Stine, M.S., BCBA
• Deirdre Tallman, OTR/L
• Tara B Nelsen, SLP, PC
• The Smile Stop LLC
• Nicholas Carmine Todaro
• Erica Mihe Von Der Lieth, D.C.
• Sonia Vulakh, D.D.S
• Amgad Wassef, RPH, MBA
• Linda Dimauro Wells, DC DOCTOR OF CHIROPR
• Thomas Burton Willingham, M.DIV.

• Chiropractor in Park Ridge, NJ
• Providers in Park Ridge, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.