Provider Demographics
NPI:1477730992
Name:LENTINE, MATHIEU (DC, CSCS)
Entity type:Individual
Prefix:DR
First Name:MATHIEU
Middle Name:
Last Name:LENTINE
Suffix:
Gender:M
Credentials:DC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 PRINCETON PIKE
Mailing Address - Street 2:BLDG 1A
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2201
Mailing Address - Country:US
Mailing Address - Phone:609-912-0440
Mailing Address - Fax:609-912-1908
Practice Address - Street 1:3131 PRINCETON PIKE
Practice Address - Street 2:BLDG 1A
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2201
Practice Address - Country:US
Practice Address - Phone:609-912-0440
Practice Address - Fax:609-912-1908
Is Sole Proprietor?:No
Enumeration Date:2008-01-28
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00668900111N00000X
PADC009995111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor