Provider Demographics
NPI:1013967926
Name:GUERRIERO-VILLANI, JASON MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:MICHAEL
Last Name:GUERRIERO-VILLANI
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 1:80 POMPTON AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:VERONA
Mailing Address - State:NJ
Mailing Address - Zip Code:07044-2945
Mailing Address - Country:US
Mailing Address - Phone:973-857-1119
Mailing Address - Fax:973-857-7480
Practice Address - Street 1:80 POMPTON AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044-2945
Practice Address - Country:US
Practice Address - Phone:973-857-1119
Practice Address - Fax:973-857-7480
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00530000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ045711Medicare ID - Type Unspecified