Provider Demographics
NPI:1346227220
Name:WASHLESKI, ROBERT A (DC, LAC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:WASHLESKI
Suffix:
Gender:M
Credentials:DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 WALTER E FORAN BLVD STE 304
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-4668
Mailing Address - Country:US
Mailing Address - Phone:908-806-6171
Mailing Address - Fax:908-806-6433
Practice Address - Street 1:4 WALTER E FORAN BLVD STE 304
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822
Practice Address - Country:US
Practice Address - Phone:908-806-6171
Practice Address - Fax:908-806-6433
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00006500171100000X
NJ38MC00299200111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5385601Medicaid
NJ5385601Medicaid
NJT77853Medicare UPIN