Provider Demographics
NPI:1235736992
Name:FENNIMORE, ROBERT F (DC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:F
Last Name:FENNIMORE
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 1:1338 LITTLETON RD
Mailing Address - Street 2:
Mailing Address - City:MORRIS PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07950-3150
Mailing Address - Country:US
Mailing Address - Phone:973-699-1562
Mailing Address - Fax:
Practice Address - Street 1:222 NORTH AVE W
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-1495
Practice Address - Country:US
Practice Address - Phone:908-928-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-06
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00774200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor