Organization Active NPI

Family Chiropractors of Montclair LLC

  • Chiropractor
  • Montclair, NJ
National Provider Identifier
1861615916
Registry record updated Jul 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00367800 Issued in NJ
Legal business name
FAMILY CHIROPRACTORS OF MONTCLAIR LLC
Practice address
39 Watchung PLZ
Montclair, NJ 07042-4117
Phone
(973) 783-5666
Fax
(973) 783-7209
NPI assigned
Apr 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2010

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

Authorized official

Name
Dr. Jayne Mizraji, DC
Title
Owner
Phone
(973) 783-5666

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 38MC00367800 NJ Primary

Addresses

Primary practice location

39 Watchung PLZ
Montclair, NJ 07042-4117

Mailing address

39 Watchung PLZ
Montclair, NJ 07042-4117
Phone (973) 783-5666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111031000373 NJ Part B Supplier - Clinic/Group Practice 9537332911 Receives reassigned benefits from 2 practitioners
Practice locations: Montclair, NJ

National Provider Directory

National Provider Directory

Locations

39 Watchung Plz
Montclair, NJ 07042
Phone (973) 783-5666

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278460800000",
    "number": "1861615916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 WATCHUNG PLZ",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070424117",
            "telephone_number": "973-783-5666",
            "fax_number": "973-783-7209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 WATCHUNG PLZ",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070424117",
            "telephone_number": "973-783-5666",
            "fax_number": "973-783-7209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CHIROPRACTORS OF MONTCLAIR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2010-07-07",
        "status": "A",
        "authorized_official_last_name": "MIZRAJI",
        "authorized_official_first_name": "JAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-783-5666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00367800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2010; 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.