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NPI Code Detail

MEDICARE: JONATHAN P MASTROBATTISTA D.C.

MEDICARE: JONATHAN P MASTROBATTISTA 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
1111N00000XChiropractor2966NJ

General Provider Information

NPI Number : 1275697104
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN P MASTROBATTISTA D.C.
Provider Business Mailing Address
First Line : 10 ANDERSON HILL ROAD
Second Line : THE CARRAIGE HOUSE
City : BERNARDSVILLE
State : NJ
Zip : 07924-2323
Country : US
Telephone Number : 908-766-3943
Fax Number :
Provider Business Practice Location Address
First Line : 10 ANDERSON HILL RD
Second Line :
City : BERNARDSVILLE
State : NJ
Zip : 07924-2323
Country : US
Telephone Number : 908-766-3943
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2006
Last Update Date : 11/15/2007

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