Provider Demographics
NPI:1275157729
Name:DISPENZIERE, MICHAEL JR (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:DISPENZIERE
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 1:55 US HIGHWAY 202
Mailing Address - Street 2:
Mailing Address - City:FAR HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07931-2445
Mailing Address - Country:US
Mailing Address - Phone:908-956-3984
Mailing Address - Fax:
Practice Address - Street 1:55 US HIGHWAY 202
Practice Address - Street 2:
Practice Address - City:FAR HILLS
Practice Address - State:NJ
Practice Address - Zip Code:07931-2445
Practice Address - Country:US
Practice Address - Phone:908-956-3984
Practice Address - Fax:732-316-4005
Is Sole Proprietor?:No
Enumeration Date:2020-06-01
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00771200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor