Provider Demographics
NPI:1174670160
Name:SANFILIPPO, EMANUEL (DC)
Entity Type:Individual
Prefix:DR
First Name:EMANUEL
Middle Name:
Last Name:SANFILIPPO
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:PO BOX 285
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-0285
Mailing Address - Country:US
Mailing Address - Phone:609-561-7247
Mailing Address - Fax:609-567-7947
Practice Address - Street 1:14 MADISON AVE S
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-1222
Practice Address - Country:US
Practice Address - Phone:609-561-7247
Practice Address - Fax:609-567-7947
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00416700111NS0005X
PADC003977L111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ855235Medicare ID - Type Unspecified
PA576043Medicare ID - Type Unspecified