Provider Demographics
NPI:1346268687
Name:SANTORO, ROCCO C (DC)
Entity Type:Individual
Prefix:DR
First Name:ROCCO
Middle Name:C
Last Name:SANTORO
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 1:327 CENTRAL AVE.
Mailing Address - Street 2:SUITE 105
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-2099
Mailing Address - Country:US
Mailing Address - Phone:609-365-8397
Mailing Address - Fax:609-365-8441
Practice Address - Street 1:327 CENTRAL AVE.
Practice Address - Street 2:SUITE 105
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-2099
Practice Address - Country:US
Practice Address - Phone:609-365-8397
Practice Address - Fax:609-365-8397
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00490900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ023597Medicare ID - Type Unspecified