Individual
MS. MANOLA TEJADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
319 BARROW ST SUITE 1A, JERSEY CITY, NJ 07302-3579
(201) 433-2096
Mailing address
319 BARROW ST SUITE 1A, JERSEY CITY, NJ 07302-3579
(201) 433-2096
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
1388
SC
111N00000X
Chiropractor
Primary
38MC00394800
NJ
111N00000X
Chiropractor
X006138-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01000765100
AMERICHOICE
NJ
05
—
1926802
—
NJ
01
—
36513
36513
NJ
01
—
58088600
GHI NUMBER
NJ
01
—
UNITED HEALTH CARE
869870
NJ
Enumeration date
10/11/2006
Last updated
10/19/2007
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