Provider Demographics
NPI:1205038478
Name:TONZOLA, JOSEPH MICHAEL (LAC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:MICHAEL
Last Name:TONZOLA
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:665 NEWARK AVE STE 406
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-2321
Mailing Address - Country:US
Mailing Address - Phone:732-232-1679
Mailing Address - Fax:732-255-8338
Practice Address - Street 1:665 NEWARK AVE STE 406
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-2321
Practice Address - Country:US
Practice Address - Phone:732-232-1679
Practice Address - Fax:732-255-8338
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00049000171100000X
NY004043171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ11639395OtherCAQH