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Organization
INJURY CARE CENTER OF EAST ORANGE
Active
Organization
INJURY CARE CENTER OF EAST ORANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FERNANDO BARRESE DC (OWNER)
(862) 930-3820
Entity
Organization
Contact information
Practice address
310 CENTRAL AVE STE 203, EAST ORANGE, NJ 07018-2838
(862) 930-3820
(862) 930-3821
Mailing address
310 CENTRAL AVE STE 203, EAST ORANGE, NJ 07018-2838
(862) 930-3820
(862) 930-3821
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
225100000X
Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MC05963
LICENSE NUMBER
NJ
Enumeration date
08/12/2022
Last updated
08/12/2022
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