Awc PT & Rehabilitation, LLC
Organization Active NPI Chiropractor · Millburn, NJ
NPI 1861543522 · NPPES record last updated Sep 11, 2025
Key facts
- NPI
- 1861543522
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 38MC00567300 (NJ)
- Legal business name
- AWC PT & REHABILITATION, LLC
- Practice address
- 96-98 Millburn Avenue
Suite #102
Millburn, NJ 07041-1944 - Phone
- (973) 486-0212
- Fax
- (973) 486-0212
- NPI assigned
- Jan 16, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Daniel Houshmand, D.C., D.I.B.E.
- Title
- Owner
- Phone
- (973) 486-0212
Practitioners 2
-
Donna M Detore, D.P.T.
-
Daniel Houshmand, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110221000639 | NJ | Part B Supplier - Clinic/Group Practice | 6204017569 |
Receives reassigned benefits from 1 practitioner Practice locations: West Orange, NJ |
National Provider Directory
Locations
96 Millburn Ave
Ste 102
Millburn, NJ 07041
Phone (973) 486-0212
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 38MC00567300 | NJ | Yes |
| Physical Therapist |
225100000X | 40QA00459400 | NJ |
Addresses
Primary practice location
96-98 Millburn Avenue
Suite #102
Millburn, NJ 07041-1944
Mailing address
96-98 Millburn Avenue
Suite #102
Millburn, NJ 07041-1944
Phone (973) 486-0212
Other providers in Millburn, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2025. 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.