| Davis Chiropractic Center Llc | |
|
316 Orange Rd, Montclair, NJ 07042-4310 | |
| (973) 783-3606 | |
| (973) 783-0158 |
| Full Name | Davis Chiropractic Center Llc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 316 Orange Rd, Montclair, New Jersey |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720104425 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 38MC00206300 (New Jersey) | Primary |
| Provider Name | Peter T Kofitsas |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1669622437 PECOS PAC ID: 2567426448 Enrollment ID: I20041119000351 |
| Provider Name | Guy E Margolin |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1104998889 PECOS PAC ID: 2668545237 Enrollment ID: I20080716000245 |
| Provider Name | Brian A Bannister |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1588815765 PECOS PAC ID: 4981893518 Enrollment ID: I20110112000485 |
| Provider Name | Jennifer Jeanty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235680430 PECOS PAC ID: 7113207549 Enrollment ID: I20161201000166 |
| Provider Name | Akwete Sackey |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1386193514 PECOS PAC ID: 7618237967 Enrollment ID: I20180205001865 |
| Mailing Address | Practice Location Address |
|---|---|
| Davis Chiropractic Center Llc 316 Orange Rd, Montclair, NJ 07042-4310 Ph: (973) 783-3606 | Davis Chiropractic Center Llc 316 Orange Rd, Montclair, NJ 07042-4310 Ph: (973) 783-3606 |
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