Provider Demographics
NPI:1043058928
Name:OMEGA CHIROPRACTIC SERVICES LLC
Entity type:Organization
Organization Name:OMEGA CHIROPRACTIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ASHFAQ
Authorized Official - Middle Name:
Authorized Official - Last Name:TIRMIZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-355-6162
Mailing Address - Street 1:452 TOURNAMENT DR UNIT 9
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-8764
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:154 E FRONT ST
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060-1202
Practice Address - Country:US
Practice Address - Phone:908-548-8684
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center