Provider Demographics
NPI:1255538716
Name:CIRINO, WILLIAM VICTOR JR (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:VICTOR
Last Name:CIRINO
Suffix:JR
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 1:514 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07506-2422
Mailing Address - Country:US
Mailing Address - Phone:973-427-6663
Mailing Address - Fax:973-427-2363
Practice Address - Street 1:514 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:NJ
Practice Address - Zip Code:07506-2422
Practice Address - Country:US
Practice Address - Phone:973-427-6663
Practice Address - Fax:973-427-2363
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00163000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ532481Medicare ID - Type Unspecified