Executive Spinal Care, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

38MC00640400 Issued in NJ

Legal business name

EXECUTIVE SPINAL CARE, LLC

Practice address

36 Douglas Dr
Towaco, NJ 07082-1437

Phone

(973) 477-3470

Fax

(973) 616-2921

NPI assigned

May 8, 2007

Last updated

Nov 6, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Peter Walsh, D.C.NPI 1124232905

Title

Member

Phone

(973) 477-3470

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Peter Joseph Walsh, D.C.

  • Chiropractor
  • Towaco, NJ
  • NPI 1124232905
  Authorized official Same address or phone

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509926400000",
    "number": "1497968077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 DOUGLAS DR",
            "city": "TOWACO",
            "state": "NJ",
            "postal_code": "070821437",
            "telephone_number": "973-477-3470",
            "fax_number": "973-616-2921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 DOUGLAS DR",
            "city": "TOWACO",
            "state": "NJ",
            "postal_code": "070821437",
            "telephone_number": "973-477-3470",
            "fax_number": "973-616-2921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXECUTIVE SPINAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2017-11-06",
        "status": "A",
        "authorized_official_last_name": "WALSH",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "973-477-3470",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00640400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Bienskie-Jackson
• Rhiannon Campagna, RDN
• Maria Ann Cuocci, ACAGNP-BC, MSN, BSN
• Susan D'Agostino
• Christopher Duddy, D.M.D.
• Susan M. Ferrante, LSW, LCADC
• Guardian Recovery Montville Adolescent Center
• Kathleen Anne Haft, R.PH
• Innovative Eye Associates Inc.
• Claudia A. Irmiere, RN, APN

• Chiropractor in Towaco, NJ
• Providers in Towaco, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.