Provider Demographics
NPI:1447322508
Name:CULVER, THOMAS ERIC (DC)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ERIC
Last Name:CULVER
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 1:1490 SPRINGFIELD AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:NEW PROVIDENCE
Mailing Address - State:NJ
Mailing Address - Zip Code:07974-1423
Mailing Address - Country:US
Mailing Address - Phone:908-508-1212
Mailing Address - Fax:908-508-9211
Practice Address - Street 1:1490 SPRINGFIELD AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:NEW PROVIDENCE
Practice Address - State:NJ
Practice Address - Zip Code:07974-1423
Practice Address - Country:US
Practice Address - Phone:908-508-1212
Practice Address - Fax:908-508-9211
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC03269111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DD0363Medicare PIN
NJ084658Medicare PIN