Provider Demographics
NPI:1851456784
Name:MASTROBATTISTA CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:MASTROBATTISTA CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:MASTROBATTISTA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:908-766-3943
Mailing Address - Street 1:10 ANDERSON HILL RD
Mailing Address - Street 2:
Mailing Address - City:BERNARDSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07924-2323
Mailing Address - Country:US
Mailing Address - Phone:908-766-3943
Mailing Address - Fax:
Practice Address - Street 1:10 ANDERSON HILL RD
Practice Address - Street 2:
Practice Address - City:BERNARDSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07924-2323
Practice Address - Country:US
Practice Address - Phone:908-766-3943
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2966111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty