Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 3341 | NJ |
NPI | 1023179405 |
---|---|
Provider Name | Dr. Jay E Brecker |
First Address | Dover, NJ 07801-3748 |
Second Address | Dover, NJ 07801-3748 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2006 |
Last Update Date | 08/07/2007 |