Provider Demographics
NPI:1053493718
Name:JAKUBCZAK, ARTHUR (DC)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:
Last Name:JAKUBCZAK
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 1:465 RATHBURN PL
Mailing Address - Street 2:
Mailing Address - City:PERTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08861-3609
Mailing Address - Country:US
Mailing Address - Phone:732-324-1115
Mailing Address - Fax:732-324-1686
Practice Address - Street 1:465 RATHBURN PL
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-3609
Practice Address - Country:US
Practice Address - Phone:732-324-1115
Practice Address - Fax:732-324-1686
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00401900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U17843Medicare UPIN
673013Medicare ID - Type Unspecified