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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