Provider Demographics
NPI:1457406001
Name:DEPAOLIS, ROBERT H (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:H
Last Name:DEPAOLIS
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 1:985 BELVIDERE RD
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-1778
Mailing Address - Country:US
Mailing Address - Phone:610-351-3591
Mailing Address - Fax:
Practice Address - Street 1:985 BELVIDERE RD
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-1778
Practice Address - Country:US
Practice Address - Phone:908-859-1919
Practice Address - Fax:908-859-9808
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMCO3515111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU01563Medicare UPIN
NJ000557468Medicare ID - Type Unspecified