Provider Demographics
NPI:1770253098
Name:BUFFAMONTE, MCKEON (DC)
Entity Type:Individual
Prefix:DR
First Name:MCKEON
Middle Name:
Last Name:BUFFAMONTE
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 1:137 ERVIN AVE
Mailing Address - Street 2:
Mailing Address - City:LINWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19061-4315
Mailing Address - Country:US
Mailing Address - Phone:610-757-8957
Mailing Address - Fax:
Practice Address - Street 1:1873 ROUTE 70 E STE 1-J
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2034
Practice Address - Country:US
Practice Address - Phone:856-428-4030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-17
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011657111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor