Provider Demographics
NPI:1568524049
Name:SCOPELLITI, ALDO R (DC)
Entity Type:Individual
Prefix:DR
First Name:ALDO
Middle Name:R
Last Name:SCOPELLITI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 3RD AVE
Mailing Address - Street 2:SUITE 404
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740-6205
Mailing Address - Country:US
Mailing Address - Phone:732-229-5250
Mailing Address - Fax:732-229-5280
Practice Address - Street 1:279 3RD AVE
Practice Address - Street 2:SUITE 404
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740-6205
Practice Address - Country:US
Practice Address - Phone:732-229-5250
Practice Address - Fax:732-229-5280
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00384000111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ231884Medicare PIN
NJU28120Medicare UPIN