Shoreline Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

38MC00607400 Issued in NJ

Legal business name

SHORELINE CHIROPRACTIC LLC

Practice address

1901 Hooper Ave
Suite a
Toms River, NJ 08753-1600

Phone

(732) 255-8335

Fax

(732) 255-8261

NPI assigned

May 19, 2016

Organization subpart

No

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

Authorized official

Name

Dr. John Hudak, D.C.NPI 1073686861

Title

Owner

Phone

(732) 255-8335

Specialties & licenses 1

Addresses

Other names 1

• Carskaddan Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Richard Hudak, DC

  • Chiropractor
  • Fort Lee, NJ
  • NPI 1073686861
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1463616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463616000000",
    "number": "1780031708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 HOOPER AVE",
            "address_2": "SUITE A",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087531600",
            "telephone_number": "732-255-8335",
            "fax_number": "732-255-8261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 HOOPER AVE",
            "address_2": "SUITE A",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087531600",
            "telephone_number": "732-255-8335",
            "fax_number": "732-255-8261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORELINE CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-19",
        "last_updated": "2016-05-19",
        "status": "A",
        "authorized_official_last_name": "HUDAK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-255-8335",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00607400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carskaddan Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shore Professional Services LLC
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• Shore Touch Pediatrics, LLC
• Joseph T Shore
• Shoremedical5 LLC
• Olubunmi Adejumoke Shoyele, M.D
• Valerie May Gumban Sia, M.D.
• Robin Sickles
• Arshad Uddin Siddiqui

• Chiropractor in Toms River, NJ
• Providers in Toms River, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.