Organization
BLEEKER STREET CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY FAVA DC (OWNER)
(973) 230-4222
Entity
Organization
Contact information
Practice address
45 BLEEKER ST, FIRST FLOOR, NEWARK, NJ 07102-1913
(973) 230-4222
(973) 230-2260
Mailing address
45 BLEEKER ST, FIRST FLOOR, NEWARK, NJ 07102-1913
(973) 230-4222
(973) 230-2260
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
MC04563
NJ
Other
Enumeration date
09/24/2013
Last updated
09/24/2013
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