Provider Demographics
NPI:1104973551
Name:LEVENTHAL FAMILY CHIROPRACTIC P.C.
Entity type:Organization
Organization Name:LEVENTHAL FAMILY CHIROPRACTIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:S
Authorized Official - Last Name:LEVENTHAL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:908-322-8887
Mailing Address - Street 1:1949 WESTFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTCH PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07076-1717
Mailing Address - Country:US
Mailing Address - Phone:908-322-8887
Mailing Address - Fax:908-322-7888
Practice Address - Street 1:1949 WESTFIELD AVE
Practice Address - Street 2:
Practice Address - City:SCOTCH PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07076-1717
Practice Address - Country:US
Practice Address - Phone:908-322-8887
Practice Address - Fax:908-322-7888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00487900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7139306Medicaid
NJ7139306Medicaid
NJLE894084Medicare ID - Type Unspecified