Provider Demographics
NPI:1174578488
Name:ALTMAN FAMILY CHIROPRACTIC, PA
Entity type:Organization
Organization Name:ALTMAN FAMILY CHIROPRACTIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:ALTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:609-927-7922
Mailing Address - Street 1:2106 NEW RD
Mailing Address - Street 2:SUITE D2
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-1046
Mailing Address - Country:US
Mailing Address - Phone:609-927-7922
Mailing Address - Fax:609-927-2039
Practice Address - Street 1:2106 NEW RD
Practice Address - Street 2:SUITE D2
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1046
Practice Address - Country:US
Practice Address - Phone:609-927-7922
Practice Address - Fax:609-927-2039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1458288OtherAMERIHEALTH PPO
NJ2143569000OtherAMERIHEALTH HMO/POS
NJ060820Medicare PIN