Organization
FAMILY CHIROPRACTIC OF CLARK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRICIA MASTROPIETRO BA DC (OWNER)
(732) 388-3828
Entity
Organization
Contact information
Practice address
1114 RARITAN RD, SUITE 4, CLARK, NJ 07066-1330
(732) 388-3828
(732) 388-3829
Mailing address
1114 RARITAN RD, SUITE 4, CLARK, NJ 07066-1330
(732) 388-3828
(732) 388-3829
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38MC00600800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3698573
AETNA ID #
NJ
01
—
P00192623
MEDICARE RAILROAD
NJ
01
—
P2901780
OXFORD ID
NJ
Enumeration date
05/24/2007
Last updated
04/09/2014
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