Provider Demographics
NPI:1528137536
Name:FEDERICO, JOSEPH (DC)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:FEDERICO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 HWY 35
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701
Mailing Address - Country:US
Mailing Address - Phone:732-219-0044
Mailing Address - Fax:732-219-8830
Practice Address - Street 1:225 HWY 35
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701
Practice Address - Country:US
Practice Address - Phone:732-219-0044
Practice Address - Fax:732-219-8830
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00221600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor