Provider Demographics
NPI:1366535866
Name:DILULLO, J. DON (DC)
Entity type:Individual
Prefix:DR
First Name:J.
Middle Name:DON
Last Name:DILULLO
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 1:170 STATE ROUTE 31
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-5756
Mailing Address - Country:US
Mailing Address - Phone:908-782-2414
Mailing Address - Fax:908-782-2449
Practice Address - Street 1:170 STATE ROUTE 31
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-5756
Practice Address - Country:US
Practice Address - Phone:908-782-2414
Practice Address - Fax:908-782-2449
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00220900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU17805Medicare UPIN
NJDI458672Medicare ID - Type Unspecified