Provider Demographics
NPI:1710008073
Name:SALAMONE, JOSEPH DOMINICK (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:DOMINICK
Last Name:SALAMONE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:JOSEPH
Other - Middle Name:
Other - Last Name:SALAMONE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:22 CARLOS DRIVE
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07004
Mailing Address - Country:US
Mailing Address - Phone:973-227-3456
Mailing Address - Fax:973-808-9656
Practice Address - Street 1:22 CARLOS DRIVE
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07004
Practice Address - Country:US
Practice Address - Phone:973-227-3456
Practice Address - Fax:973-808-9656
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00366100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T87611Medicare UPIN
NJSA467096Medicare ID - Type Unspecified