Prime Chiropractic PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

012249 Issued in NJ

Legal business name

PRIME CHIROPRACTIC PC

Practice address

118 Broad Ave
Suite N10
Palisades Park, NJ 07650-2717

Phone

(201) 313-1122

Fax

(201) 941-1157

NPI assigned

Jun 4, 2014

Organization subpart

No

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

Authorized official

Name

Dongsun Park

Title

President

Phone

(201) 446-6701

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1401840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401840000000",
    "number": "1487067724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 BROAD AVE",
            "address_2": "SUITE N10",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "076502717",
            "telephone_number": "201-313-1122",
            "fax_number": "201-941-1157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 BROAD AVE",
            "address_2": "SUITE N10",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "076502717",
            "telephone_number": "201-313-1122",
            "fax_number": "201-941-1157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-04",
        "last_updated": "2014-06-04",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "DONGSUN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-446-6701"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "012249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Palisades Park, NJ
• Providers in Palisades Park, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2014; 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.