Provider Demographics
NPI:1114976222
Name:ALTIERI, PHILIP S (DC)
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:S
Last Name:ALTIERI
Suffix:
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 1:1501 ROUTE 37 E
Mailing Address - Street 2:UNIT H
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-5785
Mailing Address - Country:US
Mailing Address - Phone:732-270-4800
Mailing Address - Fax:732-270-4838
Practice Address - Street 1:1501 ROUTE 37 E
Practice Address - Street 2:UNIT H
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-5785
Practice Address - Country:US
Practice Address - Phone:732-270-4800
Practice Address - Fax:732-270-4838
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00529100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2K8930OtherHEALTHNET
NJD09821OtherAMERIHEALTH ADMIN. PLANS
NJ3363366OtherAETNA HMO
NJP2512223OtherOXFORD
NJ5723758OtherAETNA PPO
NJ0323648000OtherAMERIHEALTH HMO
NJ2K8930OtherHEALTHNET
NJ5723758OtherAETNA PPO