Leo a. Staten DC LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

38MC00631300 Issued in NJ

Legal business name

LEO A. STATEN DC LLC

Practice address

61 Morris Ave
Neptune City, NJ 07753-6426

Phone

(732) 456-6337

Fax

(973) 695-1933

NPI assigned

Oct 23, 2014

Organization subpart

No

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

Authorized official

Name

Ms. Dimitra Denise Pallis

Title

Manager

Phone

(201) 874-9084

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

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

• Leo Abram Staten, D.C.

  • Chiropractor
  • Neptune City, NJ
  • NPI 1063563625
  Medicare reassignment NPD

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

{
    "created_epoch": "1414022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440979200000",
    "number": "1407251218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51",
            "city": "LEDGEWOOD",
            "state": "NJ",
            "postal_code": "078520051",
            "telephone_number": "201-874-9084",
            "fax_number": "973-695-1933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 MORRIS AVE",
            "city": "NEPTUNE CITY",
            "state": "NJ",
            "postal_code": "077536426",
            "telephone_number": "732-456-6337",
            "fax_number": "973-695-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEO A. STATEN DC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-23",
        "last_updated": "2015-08-31",
        "status": "A",
        "authorized_official_last_name": "PALLIS",
        "authorized_official_first_name": "DIMITRA",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "201-874-9084",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00631300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam J Kiernan, MA, LPC
• KMC Associates, in.
• Anoop Kotwal, M.D.
• Jennifer Kurzawa, RDN
• Hunter Lakin, DO
• Marc J. Levine, MD
• Alexandria N Llaurado, PA-C
• Making Waves Nutrition
• Cheresse Malagad
• Laurel Mallon, M.S., L.P.C.

• Chiropractor in Neptune City, NJ
• Providers in Neptune City, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.