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Individual

DR. KEVIN JUDE EMERY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
310 N MAPLE AVE, RIDGEWOOD, NJ 07450-2609
(201) 447-3707
(201) 447-0320
Mailing address
310 N MAPLE AVE, RIDGEWOOD, NJ 07450-2609
(201) 447-3707
(201) 447-0320

Taxonomy

Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
38MC00312100
NJ
111NS0005X
Sports Physician Chiropractor
X0044501
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0076805
AETNA PROVIDER IDENTIFICA
NJ
01
222854051
TAX IDENTIFICATION NUMBER
NJ
01
607510
UNITED HEALTHCARE PROVIDE
NJ
01
P643830
OXFORD PROVIDER NUMBER
NJ
Enumeration date
11/10/2006
Last updated
07/08/2007
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