Provider Demographics
NPI:1083308514
Name:CAPPELLO CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:CAPPELLO CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JODI-ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:CAPPELLO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:973-306-0043
Mailing Address - Street 1:89 SUNSET AVE
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:NJ
Mailing Address - Zip Code:07044-2610
Mailing Address - Country:US
Mailing Address - Phone:201-344-1660
Mailing Address - Fax:973-239-0921
Practice Address - Street 1:15 BLOOMFIELD AVE STE 2
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044-2700
Practice Address - Country:US
Practice Address - Phone:973-306-0043
Practice Address - Fax:973-239-0921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty