Provider Demographics
NPI:1619013406
Name:D'AGOSTINI, JOSEPH DOMINICK (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:DOMINICK
Last Name:D'AGOSTINI
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 1:2202 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-5403
Mailing Address - Country:US
Mailing Address - Phone:908-757-0377
Mailing Address - Fax:908-757-6484
Practice Address - Street 1:2202 PARK AVE
Practice Address - Street 2:
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-5403
Practice Address - Country:US
Practice Address - Phone:908-757-0377
Practice Address - Fax:908-757-6484
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00363100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor