Individual
BENJAMIN CHIANCHIANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1040 ORADELL AVE, ORADELL, NJ 07649-1954
(201) 261-1844
Mailing address
665 OTTERHOLE RD, WEST MILFORD, NJ 07480-3013
(862) 268-7677
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00224300
NJ
Other
Enumeration date
11/21/2019
Last updated
11/21/2019
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