Provider Demographics
NPI:1255404604
Name:AMOROSO-KING, KATHLEEN (D C)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:
Last Name:AMOROSO-KING
Suffix:
Gender:F
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 160
Mailing Address - Street 2:
Mailing Address - City:JAMESBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-1539
Mailing Address - Country:US
Mailing Address - Phone:732-521-0679
Mailing Address - Fax:732-521-0168
Practice Address - Street 1:315 FORSGATE DR
Practice Address - Street 2:
Practice Address - City:JAMESBURG
Practice Address - State:NJ
Practice Address - Zip Code:08831-1539
Practice Address - Country:US
Practice Address - Phone:732-521-0679
Practice Address - Fax:732-521-0168
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00488300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ005978OtherMEDICARE PROVIDER IDENTIFICATION
U69025Medicare UPIN