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Individual
ANTONIO PORTA
Active
Individual
ANTONIO PORTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38MC00743100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073052452
MEDICARE
NJ
Enumeration date
02/17/2017
Last updated
09/26/2020
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