Provider Demographics
NPI:1528159472
Name:TAMBURELLO, ANTHONY J (DC)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:J
Last Name:TAMBURELLO
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 1:1868 HOOPER AVE
Mailing Address - Street 2:UNIT #6
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-8175
Mailing Address - Country:US
Mailing Address - Phone:732-255-8000
Mailing Address - Fax:732-255-4580
Practice Address - Street 1:1868 HOOPER AVE
Practice Address - Street 2:UNIT #6
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-8175
Practice Address - Country:US
Practice Address - Phone:732-255-8000
Practice Address - Fax:732-255-4580
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00394700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U13578Medicare UPIN
NJ663586ZF3YMedicare PIN