NPIMap

Organization Active NPI

Bleeker Street Chiropractic LLC

  • Chiropractor
  • Newark, NJ
National Provider Identifier
1649606567
Registry record updated Sep 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
MC04563 Issued in NJ
Legal business name
BLEEKER STREET CHIROPRACTIC LLC
Practice address
45 Bleeker St
First Floor
Newark, NJ 07102-1913
Phone
(973) 230-4222
Fax
(973) 230-2260
NPI assigned
Sep 24, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2013

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

Authorized official

Name
Anthony Fava, DC
Title
Owner
Phone
(973) 230-4222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X MC04563 NJ Primary

Addresses

Primary practice location

45 Bleeker St
First Floor
Newark, NJ 07102-1913

Mailing address

45 Bleeker St
First Floor
Newark, NJ 07102-1913
Phone (973) 230-4222

National Provider Directory

National Provider Directory

Locations

45 Bleeker St
Fl First
Newark, NJ 07102
Phone (973) 230-4222

NPI Registry JSON

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

{
    "created_epoch": "1379980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379980800000",
    "number": "1649606567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 BLEEKER ST",
            "address_2": "FIRST FLOOR",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071021913",
            "telephone_number": "973-230-4222",
            "fax_number": "973-230-2260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 BLEEKER ST",
            "address_2": "FIRST FLOOR",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071021913",
            "telephone_number": "973-230-4222",
            "fax_number": "973-230-2260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLEEKER STREET CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-24",
        "last_updated": "2013-09-24",
        "status": "A",
        "authorized_official_last_name": "FAVA",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-230-4222",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "MC04563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2013; 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.