MEDICARE: ALTIERI CHIROPRACTIC CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	38MC00396100	NJ

General Provider Information

NPI Number	:	1750430328
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALTIERI CHIROPRACTIC CENTER LLC

Provider Business Mailing Address
First Line	:	738 ATLANTIC CITY BLVD
Second Line	:
City	:	BAYVILLE
State	:	NJ
Zip	:	08721-2543
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	738 ATLANTIC CITY BLVD
Second Line	:
City	:	BAYVILLE
State	:	NJ
Zip	:	08721-2543
Country	:	US
Telephone Number	:	732-269-4700
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CHERYL ALTIERI
Credential	:	DC
Telephone Number	:	732-269-4700

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	06/12/2008

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