Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 38MC00416700 | NJ |
N | 111NS0005X | Chiropractic Sports Physician | DC003977L | PA |
NPI | 1174670160 |
---|---|
Provider Name | Dr. Emanuel Sanfilippo |
First Address | Hammonton, NJ 08037-0285 |
Second Address | Hammonton, NJ 08037-1222 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 08/07/2007 |