Organization
MAPLEWOOD CHIROPRACTIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOMINIC MAZZA DC (PRESIDENT)
(201) 317-6104
Entity
Organization
Contact information
Practice address
36 LYDIA DR, GUTTENBERG, NJ 07093-8366
(201) 317-6104
Mailing address
36 LYDIA DR, GUTTENBERG, NJ 07093-8366
(201) 317-6104
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38MC00553500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38MC00553500
NJ LICENSE NUMBER
NJ
01
—
X009462-1
NY LICENSE
NJ
Enumeration date
07/15/2014
Last updated
07/15/2014
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