Provider Demographics
NPI:1881426369
Name:DIGIOVANNI, TYLER J (DC)
Entity type:Individual
Prefix:DR
First Name:TYLER
Middle Name:J
Last Name:DIGIOVANNI
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 1:20 SUN HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-1865
Mailing Address - Country:US
Mailing Address - Phone:732-330-5305
Mailing Address - Fax:
Practice Address - Street 1:70 SCHANCK RD UNIT EAST
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-5309
Practice Address - Country:US
Practice Address - Phone:732-330-5305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-14
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00804400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty