Individual
DR. DOMINICK ANTHONY DAGOSTINO JR.
Active
Individual
DR. DOMINICK ANTHONY DAGOSTINO JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
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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