Pro Health Sports and Wellness Center Rockaway LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

PRO HEALTH SPORTS AND WELLNESS CENTER ROCKAWAY LLC

Practice address

350 Route 46
Rockaway, NJ 07866-3827

Phone

(973) 627-7888

NPI assigned

Aug 16, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Derrick Lawlor, DO

Title

MD/Owner

Phone

(973) 627-7888

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1502841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503619200000",
    "number": "1417473950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 E MAIN ST",
            "city": "DENVILLE",
            "state": "NJ",
            "postal_code": "078342647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 ROUTE 46",
            "city": "ROCKAWAY",
            "state": "NJ",
            "postal_code": "078663827",
            "telephone_number": "973-627-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO HEALTH SPORTS AND WELLNESS CENTER ROCKAWAY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-16",
        "last_updated": "2017-08-25",
        "status": "A",
        "authorized_official_last_name": "LAWLOR",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "973-627-7888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2017; 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.