Provider Demographics
NPI:1447314927
Name:VARGAS, ALLAN STEVEN (DC)
Entity type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:STEVEN
Last Name:VARGAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1064 CLINTON AVE
Mailing Address - Street 2:185
Mailing Address - City:IRVINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07111-3549
Mailing Address - Country:US
Mailing Address - Phone:973-374-1840
Mailing Address - Fax:973-374-6818
Practice Address - Street 1:1064 CLINTON AVE
Practice Address - Street 2:185
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-3549
Practice Address - Country:US
Practice Address - Phone:973-374-1840
Practice Address - Fax:973-374-6818
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MCOO251000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJVA436653Medicare ID - Type UnspecifiedMEDICARE ID NUMBER