Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NS0005X | Chiropractic Sports Physician | NJ | |
N | 111NX0800X | Chiropractor Orthopedic Specialist | 38MC00282000 | NJ |
N | 111NX0800X | Chiropractor Orthopedic Specialist | X3901 | NY |
NPI | 1538175716 |
---|---|
Provider Name | Dr. Donald C Defabio |
First Address | Berkeley Heights, NJ 07922-1278 |
Second Address | Berkeley Heights, NJ 07922-1278 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
512145 | AETNA US HEALTHCARE ID (01) | NJ |
P430270 | OXFORD ID (01) | NJ |
T45615 | (02) | NJ |