Provider Demographics
NPI:1396804217
Name:AMATO, JOSEPH J (DC)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:J
Last Name:AMATO
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 1:1476 WILLIAMSBRIDGE ROAD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-2512
Mailing Address - Country:US
Mailing Address - Phone:718-409-4900
Mailing Address - Fax:
Practice Address - Street 1:1476 WILLIAMSBRIDGE ROAD
Practice Address - Street 2:SUITE 1
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2512
Practice Address - Country:US
Practice Address - Phone:718-409-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010204-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX3811X1211Medicare UPIN