Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 38MC00130100 | NJ |
NPI | 1265643233 |
---|---|
Provider Name | Dr. Albert Stabile JR. |
First Address | Hackensack, NJ 07601-4350 |
Second Address | Hackensack, NJ 07601-4350 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
495717 | (02) | NJ |