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General NPI Number Information
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NPI Number | 1659456846
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Entity Type | Organization
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Legal Business Name | ANTONELLI CHIROPRACTIC, P.C.
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 01/06/2009
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Provider Practice Location Address
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Address Line | 2575 MORRIS AVE
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City | UNION
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State | NJ
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Zip | 07083-5613
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Country | US
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Telephone | 908-688-7373
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Fax | 908-688-8049
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Provider Business Mailing Address
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Address Line | 2575 MORRIS AVE
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City | UNION
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State | NJ
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Zip | 07083-5613
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Country | US
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Telephone | 908-688-7373
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Fax | 908-688-8049
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | DR. DONALD ANTONELLI
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Credential | D.C.
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Telephone | 908-688-7373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 38MC00425400
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License Number State | NJ
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