Provider Demographics
NPI:1659456846
Name:ANTONELLI CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:ANTONELLI CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTONELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:908-688-7373
Mailing Address - Street 1:2575 MORRIS AVE
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-5613
Mailing Address - Country:US
Mailing Address - Phone:908-688-7373
Mailing Address - Fax:908-688-8049
Practice Address - Street 1:2575 MORRIS AVE
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-5613
Practice Address - Country:US
Practice Address - Phone:908-688-7373
Practice Address - Fax:908-688-8049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00425400111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty