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1 Highland Ave Green Township NJ 07821-2201 | |
| (973) 800-6279 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 1 Highland Ave, Green Township, New Jersey |
| Authorized Official Name and Position | Courtney Centrelli-tischner (CHIROPRACTOR/OWNER) |
| Authorized Official Contact | 9738006279 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1 Highland Ave Green Township NJ 07821-2201 Ph: (973) 800-6279 | 1 Highland Ave Green Township NJ 07821-2201 Ph: (973) 800-6279 |
| NPI Number | 1881170579 |
|---|---|
| Provider Enumeration Date | 07/16/2018 |
| Last Update Date | 06/20/2023 |
| Medicare PECOS PAC ID | 7719346956 |
|---|---|
| Medicare Enrollment ID | O20230706000002 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881170579 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 00670600 (New Jersey) | Primary |
| Provider Name | Courtney Rene Centrelli-tischner |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1225273741 PECOS PAC ID: 6709942089 Enrollment ID: I20090312000064 |