Provider Demographics
NPI:1770735185
Name:DELVECCHIO, ANGELO (DC)
Entity type:Individual
Prefix:DR
First Name:ANGELO
Middle Name:
Last Name:DELVECCHIO
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 1:189 FRANKLIN AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-3823
Mailing Address - Country:US
Mailing Address - Phone:973-661-4900
Mailing Address - Fax:973-680-4668
Practice Address - Street 1:189 FRANKLIN AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-3823
Practice Address - Country:US
Practice Address - Phone:973-661-4900
Practice Address - Fax:973-680-4668
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00311200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor