Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 38MC006187 | NJ |
NPI | 1003826595 |
---|---|
Provider Name | Dr. Matthew Stralka |
First Address | Hoboken, NJ 07030-4709 |
Second Address | Hoboken, NJ 07030-4709 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 04/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
083607 | (02) | NJ |