Active NPI
Glen W Secor, DC
- Chiropractor
- Upper Saddle River, NJ
National Provider Identifier
1932259751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 38MC00320500
- Practice address
- 42 Lake St
Upper Saddle River, NJ 07458-1851 - Phone
- (201) 934-8515
- Fax
- (201) 934-8577
- NPI assigned
- Jan 12, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 38MC00320500 | NJ | Primary |
Addresses
Primary practice location
42 Lake St
Upper Saddle River, NJ 07458-1851
Mailing address
42 Lake St
Upper Saddle River, NJ 07458-1851
Phone (201) 934-8515
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38MC00320500 | NJ | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267401600000",
"number": "1932259751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "42 LAKE ST",
"city": "UPPER SADDLE RIVER",
"state": "NJ",
"postal_code": "074581851",
"telephone_number": "201-934-8515",
"fax_number": "201-934-8577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42 LAKE ST",
"city": "UPPER SADDLE RIVER",
"state": "NJ",
"postal_code": "074581851",
"telephone_number": "201-934-8515",
"fax_number": "201-934-8577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SECOR",
"first_name": "GLEN",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-12",
"last_updated": "2010-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NJ",
"license": "38MC00320500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Upper Saddle River, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.