Provider Demographics
NPI:1497819387
Name:DAMIANO, ANTHONY FRANK (DC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:FRANK
Last Name:DAMIANO
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 1:62 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-1229
Mailing Address - Country:US
Mailing Address - Phone:908-788-9269
Mailing Address - Fax:908-788-9269
Practice Address - Street 1:62 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-1229
Practice Address - Country:US
Practice Address - Phone:908-788-9269
Practice Address - Fax:908-788-9269
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2936111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ401545Medicare UPIN
NJ451-325Medicare ID - Type UnspecifiedMEDICARE PROVIDER #