Provider Demographics
NPI:1598814709
Name:SANTANGELO, SALVATORE RICHARD (DC)
Entity Type:Individual
Prefix:DR
First Name:SALVATORE
Middle Name:RICHARD
Last Name:SANTANGELO
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 1:230 CENTENNIAL AVE
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-3137
Mailing Address - Country:US
Mailing Address - Phone:908-272-2303
Mailing Address - Fax:908-272-8781
Practice Address - Street 1:230 CENTENNIAL AVE
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-3137
Practice Address - Country:US
Practice Address - Phone:908-272-2303
Practice Address - Fax:908-272-8781
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00337800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJSA178673Medicare ID - Type Unspecified