Provider Demographics
NPI:1336279397
Name:SASSO FAMILY CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:SASSO FAMILY CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:SASSO
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:732-929-3322
Mailing Address - Street 1:1174 FISCHER BLVD
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-3085
Mailing Address - Country:US
Mailing Address - Phone:732-929-3322
Mailing Address - Fax:732-929-1795
Practice Address - Street 1:1174 FISCHER BLVD
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-3085
Practice Address - Country:US
Practice Address - Phone:732-929-3322
Practice Address - Fax:732-929-1795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00270400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ605905Medicare ID - Type Unspecified
NJ454130Medicare ID - Type Unspecified