Patch Chiropractic PA

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

38MC00726900 Issued in NJ

Legal business name

PATCH CHIROPRACTIC PA

Practice address

701 E Gate Dr
Suite 304
Mount Laurel, NJ 08054-3838

Phone

(856) 677-4000

Fax

(856) 234-3014

NPI assigned

Oct 19, 2015

Organization subpart

No

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

Authorized official

Name

Mary Duffin

Title

Credentialing Specialist

Phone

(856) 677-4000

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Puja Patel, DC

  • Chiropractor
  • Mount Laurel, NJ
  • NPI 1720649254
  NPD
• Kamala N Bongiorno, MPT

  • Physical Therapist
  • Blue Bell, PA
  • NPI 1306837828
  NPD (past)

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

{
    "created_epoch": "1445212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445212800000",
    "number": "1417328295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 GLEN AVE",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080571125",
            "telephone_number": "856-335-5060",
            "fax_number": "856-793-9392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E GATE DR",
            "address_2": "SUITE 304",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080543838",
            "telephone_number": "856-677-4000",
            "fax_number": "856-234-3014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATCH CHIROPRACTIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-19",
        "last_updated": "2015-10-19",
        "status": "A",
        "authorized_official_last_name": "DUFFIN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "856-677-4000"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00726900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin M Parker, BCBA
• Corey Ann Parliament, MS, RDN
• Mary A. C. Parsons, MSW, LCSW
• Chelsey Renee Partin, CDCA
• Jemima Kezia Quintana Parungao, MA BCBA LBS LBA
• Bhavesh Patel
• Karishma Patel
• Manan J. Patel, M.D.
• Priten Patel, PHARMD
• Priyesh Patel, M.D.

• Chiropractor in Mount Laurel, NJ
• Providers in Mount Laurel, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2015; 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.