MEDICARE: DR. MICHAEL JOHN ACANFORA DC

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	38MC00502900	NJ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	083603	OTHER	NJ	MEDICARE GROUP
2	002416S66	OTHER	NJ	MEDICARE RENDERING

General Provider Information

NPI Number	:	1952315129
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL JOHN ACANFORA DC

Provider Business Mailing Address
First Line	:	734 BROADWAY
Second Line	:
City	:	BAYONNE
State	:	NJ
Zip	:	07002
Country	:	US
Telephone Number	:	201-858-0444
Fax Number	:	201-858-4049

Provider Business Practice Location Address
First Line	:	120 LEFANTE WAY STE 1
Second Line	:
City	:	BAYONNE
State	:	NJ
Zip	:	07002-5060
Country	:	US
Telephone Number	:	201-858-4444
Fax Number	:	201-858-4049

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	10/25/2021

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