Provider Demographics
NPI:1104104967
Name:JOFFE CHIROPRACTIC PC
Entity type:Organization
Organization Name:JOFFE CHIROPRACTIC PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:WADE
Authorized Official - Last Name:JOFFE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-350-1188
Mailing Address - Street 1:67 LACEY RD STE 2
Mailing Address - Street 2:
Mailing Address - City:WHITING
Mailing Address - State:NJ
Mailing Address - Zip Code:08759-2912
Mailing Address - Country:US
Mailing Address - Phone:732-350-1188
Mailing Address - Fax:732-341-2450
Practice Address - Street 1:75 LACEY RD
Practice Address - Street 2:SUITE 3
Practice Address - City:WHITING
Practice Address - State:NJ
Practice Address - Zip Code:08759-2938
Practice Address - Country:US
Practice Address - Phone:732-350-1188
Practice Address - Fax:732-341-2450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-28
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0002332111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJUO1990Medicare UPIN
NJ608066Medicare PIN