Organization
PURE LIFE CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT ROSANIA JR. D.C. (CHIROPRACTOR)
(973) 768-3651
Entity
Organization
Contact information
Practice address
16 WATSESSING AVE, BLOOMFIELD, NJ 07003
(973) 768-3651
Mailing address
81 GLENROY RD EAST, FAIRFIELD, NJ 07004
(973) 768-3651
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
38MC00648300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
$$$$$$$$$
SOCIAL SECURITY NUMBER
NJ
Enumeration date
12/14/2006
Last updated
08/22/2020
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