Healthcare Provider Details

I. General information

NPI: 1205906393
Provider Name (Legal Business Name): MICHAEL JOHN ORLANDO D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 10/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1806 SPRINGFIELD AVE
NEW PROVIDENCE NJ
07974-1005
US

IV. Provider business mailing address

402 SOUTH ST SUITE 103
NEW PROVIDENCE NJ
07974-2129
US

V. Phone/Fax

Practice location:
  • Phone: 908-771-0707
  • Fax: 908-665-2067
Mailing address:
  • Phone: 718-344-5902
  • Fax: 516-208-9360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberX005624
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License NumberX005624
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number38MC00736900
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License NumberF1-0000868
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: