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NPI Code Detail

MEDICARE: DIBARTOLO CHIROPRACTIC, LLC

MEDICARE: DIBARTOLO CHIROPRACTIC, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor38MC00311300NJ

General Provider Information

NPI Number : 1043373640
Entity Type Code : Organization
Provider Name (Legal Business Name) : DIBARTOLO CHIROPRACTIC, LLC
Provider Business Mailing Address
First Line : 4036 OCEAN HEIGHTS AVE
Second Line :
City : EGG HARBOR TOWNSHIP
State : NJ
Zip : 08234-7505
Country : US
Telephone Number : 609-926-1100
Fax Number : 609-926-0054
Provider Business Practice Location Address
First Line : 4036 OCEAN HEIGHTS AVE
Second Line :
City : EGG HARBOR TOWNSHIP
State : NJ
Zip : 08234-7505
Country : US
Telephone Number : 609-926-1100
Fax Number : 609-926-0054
Authorized Official
Title or Position : OWNER CHIROPRACTOR
Name : DR. PHILIP ANTHONY DIBARTOLO
Credential : DC
Telephone Number : 609-926-1100
Provider Enumeration Date : 12/18/2006
Last Update Date : 01/27/2016

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Directions to “DIBARTOLO CHIROPRACTIC, LLC ” Practice Location

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