Provider Demographics
NPI:1053477208
Name:DI NARDO, THOMAS EMIL JR (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:EMIL
Last Name:DI NARDO
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4870 HYLAN BLVD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-6322
Mailing Address - Country:US
Mailing Address - Phone:718-227-6999
Mailing Address - Fax:718-227-6969
Practice Address - Street 1:4870 HYLAN BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-6322
Practice Address - Country:US
Practice Address - Phone:718-227-6999
Practice Address - Fax:718-227-6969
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011136111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor