Individual provider Active NPI

Charles Joseph Bronder Jr., D.C.

  • Sports Physician Chiropractor
  • Englewood Cliffs, NJ
National Provider Identifier
1760689632
Registry record updated Nov 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
3261 Issued in NJ
Practice address
333 Sylvan Ave Ste 301
Englewood Cliffs, NJ 07632-2733
Phone
(973) 851-9188
NPI assigned
Jul 2, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 3261 NJ Primary

Addresses

Primary practice location

333 Sylvan Ave Ste 301
Englewood Cliffs, NJ 07632-2733

Mailing address

149 Horseneck Rd
Fairfield, NJ 07004-2306
Phone (973) 851-9188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3261NJMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile Sports Chiropractic, LLC Sports Physician Past Accepting new patients
Advanced Spine & Sports Performance Sports Physician Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384905600000",
    "number": "1760689632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 HORSENECK RD",
            "city": "FAIRFIELD",
            "state": "NJ",
            "postal_code": "070042306",
            "telephone_number": "973-851-9188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 SYLVAN AVE STE 301",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076322733",
            "telephone_number": "973-851-9188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRONDER",
        "first_name": "CHARLES",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-02",
        "last_updated": "2013-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "NJ",
            "license": "3261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood Cliffs, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.