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NPI Code Detail

MEDICARE: DR. DARYL SUSAN MITRUSKA D.C.

MEDICARE: DR. DARYL SUSAN MITRUSKA D.C.
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
1111N00000XChiropractorMC04382NJ

General Provider Information

NPI Number : 1104870310
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DARYL SUSAN MITRUSKA D.C.
Provider Business Mailing Address
First Line : 453 AMBOY AVE STE 1
Second Line :
City : WOODBRIDGE
State : NJ
Zip : 07095-2949
Country : US
Telephone Number : 732-324-4300
Fax Number : 732-324-8211
Provider Business Practice Location Address
First Line : 453 AMBOY AVE
Second Line :
City : WOODBRIDGE
State : NJ
Zip : 07095-2960
Country : US
Telephone Number : 732-324-4300
Fax Number : 732-324-8211
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2006
Last Update Date : 01/07/2026

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