Provider Demographics
NPI:1912694530
Name:ALTAMURA, MITCHEL J (DC)
Entity Type:Individual
Prefix:DR
First Name:MITCHEL
Middle Name:J
Last Name:ALTAMURA
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 1:1314 ENGLISHTOWN RD
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-1580
Mailing Address - Country:US
Mailing Address - Phone:732-723-0023
Mailing Address - Fax:732-723-1614
Practice Address - Street 1:1314 ENGLISHTOWN RD
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-1580
Practice Address - Country:US
Practice Address - Phone:732-723-0023
Practice Address - Fax:732-723-1614
Is Sole Proprietor?:No
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00797600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor