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Individual

DR. DOMINICK ANTHONY DAGOSTINO JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
96 MANNER AVE, GARFIELD, NJ 07026-1418
(973) 772-0099
(973) 772-0099
Mailing address
96 MANNER AVE, GARFIELD, NJ 07026-1418
(973) 772-0099
(973) 772-0099

Taxonomy

Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
38MC00541800
NJ
111NS0005X
Sports Physician Chiropractor
X009210-0
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
22-365-5167
TAX ID
NJ
05
7971907
NJ
Enumeration date
11/29/2006
Last updated
03/17/2009
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