Provider Demographics
NPI:1487730263
Name:FAMILY CHIROPRACTIC CENTER OF BAYONNE PA
Entity type:Organization
Organization Name:FAMILY CHIROPRACTIC CENTER OF BAYONNE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NOAH
Authorized Official - Middle Name:
Authorized Official - Last Name:DEKOYER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-437-0033
Mailing Address - Street 1:734 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002
Mailing Address - Country:US
Mailing Address - Phone:201-437-0033
Mailing Address - Fax:201-858-4049
Practice Address - Street 1:734 BROADWAY
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-3948
Practice Address - Country:US
Practice Address - Phone:201-443-7003
Practice Address - Fax:201-858-4049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ050645PIUMedicare ID - Type Unspecified