Provider Demographics
NPI:1588753602
Name:CANTALUPO, DONNA JEAN (DC)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:JEAN
Last Name:CANTALUPO
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 1:24 MICHAEL LN
Mailing Address - Street 2:
Mailing Address - City:EAST HANOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07936-3733
Mailing Address - Country:US
Mailing Address - Phone:973-585-7395
Mailing Address - Fax:
Practice Address - Street 1:460 RIDGEDALE AVE
Practice Address - Street 2:
Practice Address - City:EAST HANOVER
Practice Address - State:NJ
Practice Address - Zip Code:07936-1442
Practice Address - Country:US
Practice Address - Phone:973-887-5353
Practice Address - Fax:973-887-1151
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00338600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor