Provider Demographics
NPI:1154343127
Name:NIXDORF, KARL W (DC)
Entity type:Individual
Prefix:
First Name:KARL
Middle Name:W
Last Name:NIXDORF
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 E PALISADE AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632-1831
Mailing Address - Country:US
Mailing Address - Phone:201-871-4100
Mailing Address - Fax:201-871-1627
Practice Address - Street 1:617 E PALISADE AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD CLIFFS
Practice Address - State:NJ
Practice Address - Zip Code:07632-1831
Practice Address - Country:US
Practice Address - Phone:201-871-4100
Practice Address - Fax:201-871-1627
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00468200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ796380Medicare ID - Type Unspecified
NJU57712Medicare UPIN