Provider Demographics
NPI:1205906393
Name:ORLANDO, MICHAEL JOHN (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOHN
Last Name:ORLANDO
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 1:402 SOUTH ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:NEW PROVIDENCE
Mailing Address - State:NJ
Mailing Address - Zip Code:07974-2129
Mailing Address - Country:US
Mailing Address - Phone:718-344-5902
Mailing Address - Fax:516-208-9360
Practice Address - Street 1:1806 SPRINGFIELD AVE
Practice Address - Street 2:
Practice Address - City:NEW PROVIDENCE
Practice Address - State:NJ
Practice Address - Zip Code:07974-1005
Practice Address - Country:US
Practice Address - Phone:908-771-0707
Practice Address - Fax:908-665-2067
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX005624111NS0005X, 111NN0400X
NJ38MC00736900111NN0400X
DEF1-0000868111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
No111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT91454Medicare UPIN
NY04450HMedicare ID - Type UnspecifiedMEDICARE PROVIDER #