Provider Demographics
NPI:1386284347
Name:CHIPELO, MANUEL JOSEPH
Entity type:Individual
Prefix:MR
First Name:MANUEL
Middle Name:JOSEPH
Last Name:CHIPELO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1218 CARLTON TER
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-4111
Mailing Address - Country:US
Mailing Address - Phone:973-207-6332
Mailing Address - Fax:
Practice Address - Street 1:1218 CARLTON TER
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-4111
Practice Address - Country:US
Practice Address - Phone:973-207-6332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst