Provider Demographics
NPI:1275673360
Name:AMATO, CARLO EUGENIO (DC)
Entity Type:Individual
Prefix:DR
First Name:CARLO
Middle Name:EUGENIO
Last Name:AMATO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:CARLO
Other - Middle Name:EUGENIO
Other - Last Name:AMATO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC,
Mailing Address - Street 1:1221 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-1751
Mailing Address - Country:US
Mailing Address - Phone:732-364-3366
Mailing Address - Fax:732-364-5572
Practice Address - Street 1:1221 MADISON AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-1751
Practice Address - Country:US
Practice Address - Phone:732-364-3366
Practice Address - Fax:732-364-5572
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00307200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor