Provider Demographics
NPI:1780351858
Name:POMA, SEBASTIAN ANTHONY (DC)
Entity type:Individual
Prefix:DR
First Name:SEBASTIAN
Middle Name:ANTHONY
Last Name:POMA
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 1:67 HAZEN CT APT A
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-3214
Mailing Address - Country:US
Mailing Address - Phone:407-761-7755
Mailing Address - Fax:
Practice Address - Street 1:17 HANOVER RD STE 300
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1415
Practice Address - Country:US
Practice Address - Phone:973-240-7251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00785000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor