Provider Demographics
NPI:1881613834
Name:DIMAIO, RALPH J (DC)
Entity type:Individual
Prefix:DR
First Name:RALPH
Middle Name:J
Last Name:DIMAIO
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 1:625 JORALEMON ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-1852
Mailing Address - Country:US
Mailing Address - Phone:973-751-8805
Mailing Address - Fax:973-450-8026
Practice Address - Street 1:625 JORALEMON ST
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-1852
Practice Address - Country:US
Practice Address - Phone:973-751-8805
Practice Address - Fax:973-450-8026
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC01802111NR0200X, 111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111NR0200XChiropractic ProvidersChiropractorRadiology
Not Answered111NX0100XChiropractic ProvidersChiropractorOccupational Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1181602Medicaid
NJ1181602Medicaid
NJT45592Medicare UPIN