Provider Demographics
NPI:1023227550
Name:TOMBURO, JOHN FRANK II (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:FRANK
Last Name:TOMBURO
Suffix:II
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 WESTON ST
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-2845
Mailing Address - Country:US
Mailing Address - Phone:973-667-8061
Mailing Address - Fax:973-667-8058
Practice Address - Street 1:17 WESTON ST
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-2845
Practice Address - Country:US
Practice Address - Phone:973-667-8061
Practice Address - Fax:973-667-8058
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00620200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor