JSP Chiropractic LLC
Organization Active NPI Chiropractor · Palisades Park, NJ
NPI 1518657352 · NPPES record last updated Aug 28, 2023
Key facts
- NPI
- 1518657352
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- JSP CHIROPRACTIC LLC
- Practice address
- 17 Brinkerhoff Ter # 202
Palisades Park, NJ 07650-1101 - Phone
- (201) 313-1212
- NPI assigned
- May 12, 2023
- Organization subpart
- No
Authorized official
- Name
- Joseph Sungjae Park, DC
- Title
- Chiropractor
- Phone
- (201) 388-5332
Practitioners 2
-
Junho Roh, PT, DPT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230828000036 | NJ | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 5698138485 |
Receives reassigned benefits from 1 practitioner Practice locations: Closter, NJ; Palisades Park, NJ |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
Addresses
Primary practice location
17 Brinkerhoff Ter # 202
Palisades Park, NJ 07650-1101
Mailing address
555 Gorge Rd Apt 5F
Cliffside Park, NJ 07010-2240
Phone (201) 388-5332
Other providers in Palisades Park, NJ
- Jinyoung Sarah Jin
- Peter Hyungbaik Jin
- Wenji Jin
- Jeannie S Joo
- Jr Physical Therapy
- Daniel Jung
- Hae Y Jung
- Kyonghwa Jung
- Richard K Jung
- Yeonsun Jung
All providers in Palisades Park, NJ · Chiropractor in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 28, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.