=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578654307
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHRISTOPHER DONOFRI D.C.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/27/2006
-----------------------------------------------------
Last Update Date | 01/13/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 167 AVENUE AT THE CMN 2ND FLOOR STE 12
-----------------------------------------------------
City | SHREWSBURY
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07702-4805
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-542-2000
-----------------------------------------------------
Fax | 732-542-2044
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 167 AVENUE AT THE CMN 2ND FLOOR STE 12
-----------------------------------------------------
City | SHREWSBURY
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07702-4805
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-542-2000
-----------------------------------------------------
Fax | 732-542-2044
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 38MC00512500
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------