Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 38MC00640200 | NJ |
NPI | 1154590164 |
---|---|
Provider Name | Dr. Michael Santino Sapienza |
First Address | Fairfield, NJ 07004 |
Second Address | Fairfield, NJ 07004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2008 |
Last Update Date | 07/07/2010 |