Individual provider Active NPI

George R Stallone, DC, CNIM

  • Chiropractor
  • Teaneck, NJ
National Provider Identifier
1417029893
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
291359-1202 Issued in UT
Practice address
1086 Teaneck Rd
Suite 4a
Teaneck, NJ 07666-4854
Phone
(201) 862-9900
Fax
(201) 862-9136
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 291359-1202 UT Primary
Specialist 174400000X 861 NY

Addresses

Primary practice location

1086 Teaneck Rd
Suite 4a
Teaneck, NJ 07666-4854

Mailing address

1086 Teaneck Rd
Suite 4a
Teaneck, NJ 07666-4854
Phone (201) 862-9900

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
291359-1202UTMDChiropractor
861NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1417029893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1086 TEANECK RD",
            "address_2": "SUITE 4A",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664854",
            "telephone_number": "201-862-9900",
            "fax_number": "201-862-9136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1086 TEANECK RD",
            "address_2": "SUITE 4A",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664854",
            "telephone_number": "201-862-9900",
            "fax_number": "201-862-9136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALLONE",
        "first_name": "GEORGE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DC, CNIM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "291359-1202",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "861",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.