Provider Demographics
NPI:1174716831
Name:D AMATO, RONALD PHILIP (DC, BCAO)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:PHILIP
Last Name:D AMATO
Suffix:
Gender:M
Credentials:DC, BCAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1040 CLIFTON AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-3511
Mailing Address - Country:US
Mailing Address - Phone:973-894-3300
Mailing Address - Fax:973-894-3299
Practice Address - Street 1:1040 CLIFTON AVE FL 2
Practice Address - Street 2:1
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-3511
Practice Address - Country:US
Practice Address - Phone:973-894-3300
Practice Address - Fax:973-894-3299
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-24
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00659300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor