Basic Information
| Provider Information | |||||||||
| NPI: | 1598995532 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NUSSBAUM | ||||||||
| FirstName: | DREW | ||||||||
| MiddleName: | JONATHAN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DREW NUSSBAUM D.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 436 ALBANY CT | ||||||||
| Address2: | |||||||||
| City: | WEST NEW YORK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070938339 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2017216130 | ||||||||
| FaxNumber: | 2019186864 | ||||||||
| Practice Location | |||||||||
| Address1: | 436 ALBANY CT | ||||||||
| Address2: | |||||||||
| City: | WEST NEW YORK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070938339 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2017216130 | ||||||||
| FaxNumber: | 2019186864 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/24/2009 | ||||||||
| LastUpdateDate: | 02/08/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 38MC00675900 | NJ | Y | Chiropractic Providers | Chiropractor |
No ID Information.