Provider Demographics
NPI:1871661629
Name:ANZALONE, MICHELANGELO (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHELANGELO
Middle Name:
Last Name:ANZALONE
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 1:81 NORTHFIELD AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-5342
Mailing Address - Country:US
Mailing Address - Phone:973-672-1870
Mailing Address - Fax:973-672-1871
Practice Address - Street 1:81 NORTHFIELD AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-5342
Practice Address - Country:US
Practice Address - Phone:973-672-1870
Practice Address - Fax:973-672-1871
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00535100111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ098564YBANMedicare UPIN