Provider Demographics
NPI:1962953679
Name:GALASSO, ADAM (DC)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:
Last Name:GALASSO
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 1:92 E MAIN ST
Mailing Address - Street 2:SUITE 411 A
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-2319
Mailing Address - Country:US
Mailing Address - Phone:908-707-9700
Mailing Address - Fax:908-218-0463
Practice Address - Street 1:92 E MAIN ST
Practice Address - Street 2:SUITE 411 A
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-2319
Practice Address - Country:US
Practice Address - Phone:908-707-9700
Practice Address - Fax:908-218-0463
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-18
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00738800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor