Provider Demographics
NPI:1346228095
Name:SPADAFINO, MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:SPADAFINO
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 1:281 SUMMERHILL ROAD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816
Mailing Address - Country:US
Mailing Address - Phone:732-254-0800
Mailing Address - Fax:732-390-5420
Practice Address - Street 1:281 SUMMERHILL ROAD
Practice Address - Street 2:SUITE 102
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816
Practice Address - Country:US
Practice Address - Phone:732-254-0800
Practice Address - Fax:732-390-5420
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-04
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC03472111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5736312OtherCIGNA
NJ0007740OtherGHI
NJ4408048OtherAETNA
NJ300089OtherASHN
NJ1025012OtherHORIZON NJ HEALTH
NJ47228OtherUNITED HEALTHCARE
NJ0111577000OtherAMERIHEALTH
NJP621873OtherOXFORD
NJX3665OtherBC/BS