Provider Demographics
NPI:1548279128
Name:VIGORITO, ANTHONY J (DC)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:J
Last Name:VIGORITO
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:RR2 BOX 225
Mailing Address - Street 2:
Mailing Address - City:DINGMANS FERRY
Mailing Address - State:PA
Mailing Address - Zip Code:18328
Mailing Address - Country:US
Mailing Address - Phone:570-828-8028
Mailing Address - Fax:570-828-8885
Practice Address - Street 1:934 MILFORD RD
Practice Address - Street 2:RR2 BOX 225
Practice Address - City:DINGMANS FERRY
Practice Address - State:PA
Practice Address - Zip Code:18328
Practice Address - Country:US
Practice Address - Phone:570-828-8028
Practice Address - Fax:570-828-8885
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009248111N00000X
PAAJ009302111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX2B882Medicare ID - Type Unspecified