Provider Demographics
NPI:1790859973
Name:PHILIP M DIPASQUALE DC, PA
Entity Type:Organization
Organization Name:PHILIP M DIPASQUALE DC, PA
Other - Org Name:ALTERNATIVE HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:M
Authorized Official - Last Name:DIPASQUALE
Authorized Official - Suffix:
Authorized Official - Credentials:DC, PA
Authorized Official - Phone:973-815-0277
Mailing Address - Street 1:2 ARNOT ST STE 3
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:NJ
Mailing Address - Zip Code:07644-1629
Mailing Address - Country:US
Mailing Address - Phone:973-815-0277
Mailing Address - Fax:973-815-0288
Practice Address - Street 1:2 ARNOT ST STE 3
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:NJ
Practice Address - Zip Code:07644-1629
Practice Address - Country:US
Practice Address - Phone:973-815-0277
Practice Address - Fax:973-815-0288
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:085396
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-20
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ2380111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP562826OtherOXFORD
NJP562826OtherOXFORD
NJP562826OtherOXFORD
NJT45358Medicare UPIN
NJ085396Medicare ID - Type Unspecified