Provider Demographics
NPI:1609113679
Name:SORIENTE, RICHARD J (DC)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:J
Last Name:SORIENTE
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 1:106 APPLE ST
Mailing Address - Street 2:STE 100C
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-2669
Mailing Address - Country:US
Mailing Address - Phone:732-747-5022
Mailing Address - Fax:
Practice Address - Street 1:810 HOOPER AVE
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-7719
Practice Address - Country:US
Practice Address - Phone:732-281-3200
Practice Address - Fax:732-276-9885
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-11
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00705600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor