Provider Demographics
NPI:1245277508
Name:FATATO, JOYCE MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:MARIE
Last Name:FATATO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 GIBBSBORO RD
Mailing Address - Street 2:
Mailing Address - City:CLEMENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08021-4134
Mailing Address - Country:US
Mailing Address - Phone:856-566-9800
Mailing Address - Fax:856-566-1323
Practice Address - Street 1:235 GIBBSBORO RD
Practice Address - Street 2:
Practice Address - City:CLEMENTON
Practice Address - State:NJ
Practice Address - Zip Code:08021-4134
Practice Address - Country:US
Practice Address - Phone:856-566-9800
Practice Address - Fax:856-566-1323
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00489300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU78981Medicare UPIN
NJ098545Medicare ID - Type Unspecified