Active NPI
SM Chiropractic&Pain Clinic, P.C.
- Chiropractor
- Fort Lee, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- MC05716
- Legal business name
- SM CHIROPRACTIC&PAIN CLINIC, P.C.
- Practice address
- 810 Abbott Blvd
#304
Fort Lee, NJ 07024-4151 - Phone
- (201) 886-7080
- Fax
- (201) 886-8069
- NPI assigned
- May 14, 2007
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Samue C. Park, D.C.
- Title
- Chiropractor
- Phone
- (201) 886-7080
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | MC05716 | NJ | Primary |
Addresses
Primary practice location
810 Abbott Blvd
#304
Fort Lee, NJ 07024-4151
Mailing address
810 Abbott Blvd
#304
Fort Lee, NJ 07024-4151
Phone (201) 886-7080
National Provider Directory
National Provider Directory- Tax ID family
- SM Chiropractic Pain Clinic PC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Chiropractor
- Edison, NJ
- NPI 1760705552
Locations
810 Abbott Blvd
Ste 304
Fort Lee, NJ 07024
Phone (201) 886-7080
Practitioners & affiliated clinicians
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.
-
- Chiropractor
- Fort Lee, NJ
- NPI 1801965918
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179100800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1518172360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "810 ABBOTT BLVD",
"address_2": "#304",
"city": "FORT LEE",
"state": "NJ",
"postal_code": "070244151",
"telephone_number": "201-886-7080",
"fax_number": "201-886-8069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "810 ABBOTT BLVD",
"address_2": "#304",
"city": "FORT LEE",
"state": "NJ",
"postal_code": "070244151",
"telephone_number": "201-886-7080",
"fax_number": "201-886-8069"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SM CHIROPRACTIC&PAIN CLINIC, P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-14",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "PARK",
"authorized_official_first_name": "SAMUE",
"authorized_official_middle_name": "C.",
"authorized_official_title_or_position": "CHIROPRACTOR",
"authorized_official_telephone_number": "201-886-7080",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.C."
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor",
"state": "NJ",
"license": "MC05716",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Lee, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.