Injury Care Center of East Orange

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

INJURY CARE CENTER OF EAST ORANGE

Practice address

310 Central Ave Ste 203
East Orange, NJ 07018-2838

Phone

(862) 930-3820

Fax

(862) 930-3821

NPI assigned

Aug 12, 2022

Last updated

Aug 12, 2022By 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

Fernando Barrese, DC

Title

Owner

Phone

(862) 930-3820

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1660262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660262400000",
    "number": "1508594979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 CENTRAL AVE STE 203",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070182838",
            "telephone_number": "862-930-3820",
            "fax_number": "862-930-3821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 CENTRAL AVE STE 203",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070182838",
            "telephone_number": "862-930-3820",
            "fax_number": "862-930-3821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INJURY CARE CENTER OF EAST ORANGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-12",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-11",
        "status": "A",
        "authorized_official_last_name": "BARRESE",
        "authorized_official_first_name": "FERNANDO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "862-930-3820",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "MC05963",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in East Orange, NJ
• Providers in East Orange, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; 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.