Provider Demographics
NPI:1144424599
Name:LAFERRERA, VITO A JR (DC)
Entity Type:Individual
Prefix:DR
First Name:VITO
Middle Name:A
Last Name:LAFERRERA
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 1:206 LIONS HEAD BLVD S
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723
Mailing Address - Country:US
Mailing Address - Phone:201-803-0202
Mailing Address - Fax:201-457-0708
Practice Address - Street 1:74 BRICK BLVD.
Practice Address - Street 2:SUITE 207 BLDG 3.
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723
Practice Address - Country:US
Practice Address - Phone:201-803-0202
Practice Address - Fax:201-457-0708
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2822111N00000X
NJ2152111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor