Provider Demographics
NPI:1366941627
Name:AMATO, NICOLA (DC)
Entity type:Individual
Prefix:
First Name:NICOLA
Middle Name:
Last Name:AMATO
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 1:99 CANNONADE DR
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-1951
Mailing Address - Country:US
Mailing Address - Phone:973-747-9410
Mailing Address - Fax:
Practice Address - Street 1:99 CANNONADE DR
Practice Address - Street 2:
Practice Address - City:MARLBORO
Practice Address - State:NJ
Practice Address - Zip Code:07746-1951
Practice Address - Country:US
Practice Address - Phone:973-747-9410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-01
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00463900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor