Provider Demographics
NPI:1699879676
Name:DOERR, GREGORY HENRY (DC)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:HENRY
Last Name:DOERR
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 1:32 FOX RUN DR
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-5051
Mailing Address - Country:US
Mailing Address - Phone:201-567-6434
Mailing Address - Fax:
Practice Address - Street 1:532 ANDERSON AVE
Practice Address - Street 2:
Practice Address - City:CLIFFSIDE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07010-1721
Practice Address - Country:US
Practice Address - Phone:201-945-4075
Practice Address - Fax:201-945-4070
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ5189111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician