Organization
PILOT MCDERMOTT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY PAUL MCDERMOTT DC (PRESIDENT)
(732) 741-8668
Entity
Organization
Contact information
Practice address
561 RIVER RD, FAIR HAVEN, NJ 07704
(732) 741-8668
(732) 842-2128
Mailing address
561 RIVER RD, FAIR HAVEN, NJ 07704
(732) 741-8668
(732) 842-2128
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
MC03327
NJ
111N00000X
Chiropractor
Primary
MC03684
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0042765
—
NJ
Enumeration date
06/19/2007
Last updated
08/22/2020
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