Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 38MC00540100 | NJ |
NPI | 1003863465 |
---|---|
Provider Name | Dr. Angel Manuel Carrion |
First Address | Hackensack, NJ 07601-5804 |
Second Address | Hackensack, NJ 07601-5804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U72383 | (02) | NJ |