Robert G Buis, DC

Individual provider Active NPI Chiropractor · Hawthorne, NJ

NPI 1417465683 · NPPES record last updated Feb 8, 2018

Key facts

NPI
1417465683
Entity type
Individual (NPI type 1)
Primary specialty
Chiropractor 111N00000X
License
38MC00750500 (NJ)
Practice address
674 Lafayette Ave
Ste 5
Hawthorne, NJ 07506-2341
Phone
(973) 423-2116
Fax
(973) 423-4114
NPI assigned
Jan 22, 2018
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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.

Medicare Care Compare profile

Specialty
Chiropractic
Education
Life Chiropractic College, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

674 Lafayette Ave
Suite 5
Hawthorne, NJ 07506-2341
Phone (973) 423-2116

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NJ

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20180301002144 NJ Practitioner - Chiropractic 0143581462 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00750500 NJ Yes

Addresses

Primary practice location

674 Lafayette Ave
Ste 5
Hawthorne, NJ 07506-2341

Mailing address

674 Lafayette Ave Ste 5
Hawthorne, NJ 07506-2341
Phone (973) 423-2116

Other providers in Hawthorne, NJ

All providers in Hawthorne, NJ · Chiropractor in New Jersey

Sources for this page

Verify at the official NPI Registry.