Healthcare Provider Details

I. General information

NPI: 1770689077
Provider Name (Legal Business Name): ALEXANDER DIMEO RPH. DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 10/11/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

647 MAIN AVE STE 202
PASSAIC NJ
07055-4934
US

IV. Provider business mailing address

29 CROMWELL DR
CHESTER NJ
07930-2153
US

V. Phone/Fax

Practice location:
  • Phone: 973-777-5400
  • Fax: 973-777-5445
Mailing address:
  • Phone: 973-670-6897
  • Fax: 908-879-2744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00301100
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28 RI01498300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: