Provider Demographics
NPI:1588725311
Name:DEOLIVEIRA, DAVID NUNES (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:NUNES
Last Name:DEOLIVEIRA
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 1:145 PASCACK RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07676
Mailing Address - Country:US
Mailing Address - Phone:908-377-5003
Mailing Address - Fax:
Practice Address - Street 1:547 MAIN ST
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601
Practice Address - Country:US
Practice Address - Phone:201-343-8282
Practice Address - Fax:201-343-4669
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00645500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor