Provider Demographics
NPI:1548439391
Name:MARSTON CHIROPRACTIC LLC
Entity type:Organization
Organization Name:MARSTON CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:MARSTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:973-838-6252
Mailing Address - Street 1:300 KAKEOUT RD
Mailing Address - Street 2:
Mailing Address - City:KINNELON
Mailing Address - State:NJ
Mailing Address - Zip Code:07405-2548
Mailing Address - Country:US
Mailing Address - Phone:973-838-6252
Mailing Address - Fax:973-838-4159
Practice Address - Street 1:300 KAKEOUT RD
Practice Address - Street 2:
Practice Address - City:KINNELON
Practice Address - State:NJ
Practice Address - Zip Code:07405-2548
Practice Address - Country:US
Practice Address - Phone:973-838-6252
Practice Address - Fax:973-838-4159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-26
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00398900111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
610247Medicare PIN
124639Medicare PIN