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General NPI Number Information
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NPI Number | 1790859973
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Entity Type | Organization
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Legal Business Name | PHILIP M DIPASQUALE DC, PA
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 04/20/2008
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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 | 973-815-0277
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Fax | 973-815-0288
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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 | 973-815-0277
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Fax | 973-815-0288
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. PHILIP M DIPASQUALE
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Credential | DC, PA
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Telephone | 973-815-0277
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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 | NJ2380
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License Number State | NJ
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