Provider Demographics
NPI:1235361429
Name:MASSARONE, JEFFREY T (ND, DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:T
Last Name:MASSARONE
Suffix:
Gender:M
Credentials:ND, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 STORY LN
Mailing Address - Street 2:
Mailing Address - City:CLINTON CORNERS
Mailing Address - State:NY
Mailing Address - Zip Code:12514-2824
Mailing Address - Country:US
Mailing Address - Phone:845-417-1041
Mailing Address - Fax:
Practice Address - Street 1:39 STORY LN
Practice Address - Street 2:
Practice Address - City:CLINTON CORNERS
Practice Address - State:NY
Practice Address - Zip Code:12514-2824
Practice Address - Country:US
Practice Address - Phone:845-417-1041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-20
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00709300111N00000X
NH131175F00000X
NY012201111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No175F00000XOther Service ProvidersNaturopath