Provider Demographics
NPI:1962719450
Name:LAULETTA, VINCENT THOMAS (DC)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:THOMAS
Last Name:LAULETTA
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 1:513 WARRENVILLE RD
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-4600
Mailing Address - Country:US
Mailing Address - Phone:908-834-8560
Mailing Address - Fax:908-834-6559
Practice Address - Street 1:513 WARRENVILLE RD
Practice Address - Street 2:SUITE 2B
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-4600
Practice Address - Country:US
Practice Address - Phone:908-834-8560
Practice Address - Fax:908-834-6559
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-07
Last Update Date:2010-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC1503111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition