Provider Demographics
NPI:1306500061
Name:CORNERSTONE HEALTH CENTERS, LLC
Entity type:Organization
Organization Name:CORNERSTONE HEALTH CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:
Authorized Official - Last Name:FERGUSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-716-9199
Mailing Address - Street 1:361 STATE ROUTE 31 STE 903
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-5797
Mailing Address - Country:US
Mailing Address - Phone:908-503-7600
Mailing Address - Fax:908-503-2008
Practice Address - Street 1:361 STATE ROUTE 31 STE 903
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-5797
Practice Address - Country:US
Practice Address - Phone:908-503-7600
Practice Address - Fax:908-503-2008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty