Provider Demographics
NPI:1316933278
Name:DEGASPERIS, THOMAS J (DC)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:J
Last Name:DEGASPERIS
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 1:532 LAFAYETTE RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-4411
Mailing Address - Country:US
Mailing Address - Phone:973-940-0423
Mailing Address - Fax:973-940-0399
Practice Address - Street 1:253 NEWTON SPARTA RD
Practice Address - Street 2:SUITE B
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-2786
Practice Address - Country:US
Practice Address - Phone:973-300-1279
Practice Address - Fax:973-300-1273
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00412600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8380503Medicaid
U57763Medicare UPIN
NJ8380503Medicaid