Provider Demographics
NPI:1124325105
Name:PRECISION UPPER CERVICAL PA
Entity type:Organization
Organization Name:PRECISION UPPER CERVICAL PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:BELLO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-857-5050
Mailing Address - Street 1:20 FRANKLIN TPKE
Mailing Address - Street 2:SUITE 218
Mailing Address - City:WALDWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:07463-1749
Mailing Address - Country:US
Mailing Address - Phone:201-857-5050
Mailing Address - Fax:201-857-5051
Practice Address - Street 1:20 FRANKLIN TPKE
Practice Address - Street 2:SUITE 218
Practice Address - City:WALDWICK
Practice Address - State:NJ
Practice Address - Zip Code:07463-1749
Practice Address - Country:US
Practice Address - Phone:201-857-5050
Practice Address - Fax:201-857-5051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-28
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00682300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty