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NPI 1164574455

NPI 1164574455 : DONNA PERILLO DC : LODI, NJ

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General NPI Number Information
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    NPI Number           |    1164574455
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    Entity Type          |    Individual 
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    Provider Name        |    DONNA PERILLO DC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/17/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    2 ARNOT ST STE 3
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    City                 |    LODI
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    State                |    NJ
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    Zip                  |    07644-1629
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    Country              |    US
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    Telephone            |    973-472-5433
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    Fax                  |    973-473-6833
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Provider Business Mailing Address
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    Address Line         |    2 ARNOT ST STE 3
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    City                 |    LODI
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    State                |    NJ
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    Zip                  |    07644-1629
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    Country              |    US
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    Telephone            |    973-472-5433
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    Fax                  |    973-473-6833
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    111N00000X
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    Taxonomy Name        |    Chiropractor
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    License Number       |    MC03737
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    License Number State |    NJ
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