Provider Demographics
NPI:1295127140
Name:DELRIO-FANO, ELAINE (DC)
Entity type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:
Last Name:DELRIO-FANO
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 1:74 HORSENECK RD
Mailing Address - Street 2:
Mailing Address - City:MONTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07045-9303
Mailing Address - Country:US
Mailing Address - Phone:973-265-0700
Mailing Address - Fax:973-265-0799
Practice Address - Street 1:74 HORSENECK RD
Practice Address - Street 2:
Practice Address - City:MONTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07045-9303
Practice Address - Country:US
Practice Address - Phone:973-265-0700
Practice Address - Fax:973-265-0799
Is Sole Proprietor?:No
Enumeration Date:2015-03-02
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00388900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor