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General NPI Number Information
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NPI Number | 1972962413
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Entity Type | Individual
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Provider Name | JORDON CENTOFANTI D.C.
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Gender | Male
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Dates
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Enumeration Date | 02/12/2016
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 669 FISCHER BLVD
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City | TOMS RIVER
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State | NJ
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Zip | 08753-4660
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Country | US
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Telephone | 732-595-7225
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Fax |
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Provider Business Mailing Address
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Address Line | 348 17TH AVE
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City | BRICK
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State | NJ
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Zip | 08724-1662
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Country | US
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Telephone | 732-684-9620
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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 | 38MC00733800
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License Number State | NJ
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