Provider Demographics
NPI:1982868931
Name:JOSEPH F. BEDNAR, DC
Entity type:Organization
Organization Name:JOSEPH F. BEDNAR, DC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:F
Authorized Official - Last Name:BEDNAR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-529-9330
Mailing Address - Street 1:180 FRANKLIN TPKE
Mailing Address - Street 2:
Mailing Address - City:MAHWAH
Mailing Address - State:NJ
Mailing Address - Zip Code:07430-1306
Mailing Address - Country:US
Mailing Address - Phone:201-529-9330
Mailing Address - Fax:
Practice Address - Street 1:180 FRANKLIN TPKE
Practice Address - Street 2:
Practice Address - City:MAHWAH
Practice Address - State:NJ
Practice Address - Zip Code:07430-1306
Practice Address - Country:US
Practice Address - Phone:201-529-9330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-17
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00240000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1036501Medicaid
NJ454658Medicare PIN
NJ1036501Medicaid