Healthcare Provider Details
I. General information
NPI: 1114334133
Provider Name (Legal Business Name): CYNTHIA D'AMELIO D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/22/2014
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
290 MADISON AVE STE 3A
MORRISTOWN NJ
07960-7401
US
IV. Provider business mailing address
290 MADISON AVE STE 3A
MORRISTOWN NJ
07960-7401
US
V. Phone/Fax
- Phone: 973-590-2448
- Fax: 973-590-2449
- Phone: 973-900-0238
- Fax: 973-590-2449
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NS0005X |
| Taxonomy | Sports Physician Chiropractor |
| License Number | 38MC00729300 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 38MC00729300 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: