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Organization
FUNCTIONAL DIAGNOSTICS PC
Active
Organization
FUNCTIONAL DIAGNOSTICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL CHILLEMI (CEO)
(732) 335-4040
Entity
Organization
Contact information
Practice address
364 BROAD ST, KEYPORT, NJ 07735-1619
(732) 335-4040
(732) 335-0516
Mailing address
364 BROAD ST, KEYPORT, NJ 07735-1619
(732) 335-4040
(732) 335-0516
Taxonomy
Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary
—
—
Other
Enumeration date
12/12/2006
Last updated
08/22/2020
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