Healthcare Provider Details

I. General information

NPI: 1205036159
Provider Name (Legal Business Name): CIFELLI CHIROPRACTIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2007
Last Update Date: 09/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W WATER ST SUITE D
TOMS RIVER NJ
08753-6533
US

IV. Provider business mailing address

300 W WATER ST SUITE D
TOMS RIVER NJ
08753-6533
US

V. Phone/Fax

Practice location:
  • Phone: 732-505-9477
  • Fax: 732-505-9577
Mailing address:
  • Phone: 732-505-9477
  • Fax: 732-505-9577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number38MC00531600
License Number StateNJ

VIII. Authorized Official

Name: DR. ANTONY CIFELLI
Title or Position: CHIROPRACTOR/OWNER
Credential: D.C.
Phone: 732-505-9477