Provider Demographics
NPI:1871291773
Name:SHAAN CHIRO LLC
Entity type:Organization
Organization Name:SHAAN CHIRO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GAGANDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:GILL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-904-1076
Mailing Address - Street 1:29 WASHINGTON AVE STE 112
Mailing Address - Street 2:
Mailing Address - City:CARTERET
Mailing Address - State:NJ
Mailing Address - Zip Code:07008-2694
Mailing Address - Country:US
Mailing Address - Phone:732-904-1076
Mailing Address - Fax:
Practice Address - Street 1:29 WASHINGTON AVE STE 112
Practice Address - Street 2:
Practice Address - City:CARTERET
Practice Address - State:NJ
Practice Address - Zip Code:07008-2694
Practice Address - Country:US
Practice Address - Phone:732-904-1076
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty