Provider Demographics
NPI:1972636702
Name:CENTER FOR ACCIDENTS AND INJURIES
Entity type:Organization
Organization Name:CENTER FOR ACCIDENTS AND INJURIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:JUSTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-960-1145
Mailing Address - Street 1:PO BOX 824
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19963-0824
Mailing Address - Country:US
Mailing Address - Phone:302-424-0556
Mailing Address - Fax:302-424-0557
Practice Address - Street 1:282B NORTH REHOBOTH BLVD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963
Practice Address - Country:US
Practice Address - Phone:302-424-0556
Practice Address - Fax:302-424-0557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE2005211233111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty