Healthcare Provider Details

I. General information

NPI: 1770086373
Provider Name (Legal Business Name): DAMON NOONAN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2018
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

387 BRICK BLVD
BRICK NJ
08723-6010
US

IV. Provider business mailing address

387 BRICK BLVD
BRICK NJ
08723-6010
US

V. Phone/Fax

Practice location:
  • Phone: 732-477-6767
  • Fax: 732-477-9333
Mailing address:
  • Phone: 732-477-6767
  • Fax: 732-477-9333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00749300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: