Provider Demographics
NPI:1033378351
Name:HEIMBUCH, RICHARD C (APN-BC)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:C
Last Name:HEIMBUCH
Suffix:
Gender:M
Credentials:APN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 FLORIAN CT
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NJ
Mailing Address - Zip Code:08759-6278
Mailing Address - Country:US
Mailing Address - Phone:732-773-8540
Mailing Address - Fax:732-377-5440
Practice Address - Street 1:22 FLORIAN CT
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NJ
Practice Address - Zip Code:08759-6278
Practice Address - Country:US
Practice Address - Phone:732-773-8540
Practice Address - Fax:732-377-5440
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2016-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00160100363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily