Provider Demographics
NPI:1346284932
Name:PATERNO, GENE (D C)
Entity Type:Individual
Prefix:DR
First Name:GENE
Middle Name:
Last Name:PATERNO
Suffix:
Gender:M
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:192 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-2204
Mailing Address - Country:US
Mailing Address - Phone:201-342-5585
Mailing Address - Fax:201-342-5586
Practice Address - Street 1:192 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-2204
Practice Address - Country:US
Practice Address - Phone:201-342-5585
Practice Address - Fax:201-342-5586
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC01984111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ436727Medicare ID - Type Unspecified