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General NPI Number Information
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NPI Number | 1770797268
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Entity Type | Individual
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Provider Name | FERNANDO BARRESE D.C.
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Gender | Male
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 08/12/2022
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Provider Practice Location Address
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Address Line | 871 ALLWOOD RD
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City | CLIFTON
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State | NJ
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Zip | 07012-1943
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Country | US
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Telephone | 973-343-5190
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Fax |
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Provider Business Mailing Address
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Address Line | 426 MORRIS AVE
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City | ELIZABETH
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State | NJ
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Zip | 07208-3609
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Country | US
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Telephone |
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Fax |
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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 | MC05963
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License Number State | NJ
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