NPI | 1316369150 |
---|---|
Entity Type | Organization |
Authorized Contact | ROBERT L DESTEFANO D.C. 201-880-8866 |
Organization Subpart ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: NJ 38MC00663300) |
Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician (Licence: NJ 38MC00663300) |
Enumeration Date | 2014-01-14 |
Last Update Date | 2014-02-11 |