Provider Demographics
NPI:1538243563
Name:ANGELOTTO, MIKE F (DC)
Entity type:Individual
Prefix:DR
First Name:MIKE
Middle Name:F
Last Name:ANGELOTTO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 CLEVELAND LN
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07866-5851
Mailing Address - Country:US
Mailing Address - Phone:908-850-0522
Mailing Address - Fax:908-850-5938
Practice Address - Street 1:254 MOUNTAIN AVE STE 5A
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-2407
Practice Address - Country:US
Practice Address - Phone:908-850-0522
Practice Address - Fax:908-850-5938
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00597200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor