Provider Demographics
NPI:1366196636
Name:MATTINA, CHRISTOPHER J (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:J
Last Name:MATTINA
Suffix:
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 1:725 RIVER RD STE 113
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-1149
Mailing Address - Country:US
Mailing Address - Phone:201-861-6800
Mailing Address - Fax:201-962-9068
Practice Address - Street 1:725 RIVER RD STE 113
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:07020-1149
Practice Address - Country:US
Practice Address - Phone:201-861-6800
Practice Address - Fax:201-962-9068
Is Sole Proprietor?:No
Enumeration Date:2022-02-07
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00789500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor