Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 38MC00623900 | NJ |
NPI | 1952332264 |
---|---|
Provider Name | Dr. David John Depalma |
First Address | Hasbrouck Heights, NJ 07604-1614 |
Second Address | Lyndhurst, NJ 07071-1269 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P3254676 | OXFORD (01) | NJ |