Provider Demographics
NPI:1477567832
Name:SIMCSAK, ROBERT JR (DC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:SIMCSAK
Suffix:JR
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 1:11 FRIENDS LN
Mailing Address - Street 2:SUITE 110
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1803
Mailing Address - Country:US
Mailing Address - Phone:215-860-3256
Mailing Address - Fax:
Practice Address - Street 1:11 FRIENDS LN
Practice Address - Street 2:SUITE 110
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1803
Practice Address - Country:US
Practice Address - Phone:215-860-3256
Practice Address - Fax:215-579-1453
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC4777L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T29670Medicare UPIN
PA675052Medicare ID - Type Unspecified