Individual
MR. DOMENIC FONTANAROSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
274 LAFAYETTE AVENUE, HAWTHORNE, NJ 07506
(973) 423-9600
(973) 423-0403
Mailing address
274 LAFAYETTE AVE, HAWTHORNE, NJ 07506
(973) 423-9600
(973) 423-0403
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
38MC00443500
NJ
111N00000X
Chiropractor
Primary
4435
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
611048100
ACS DEPT OF LABOR
—
Enumeration date
06/24/2006
Last updated
12/18/2024
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