Provider Demographics
NPI:1578561460
Name:PISKER, STEPHEN A (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:A
Last Name:PISKER
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 1:1903 KINGS HIGHWAY P.O BOX 217
Mailing Address - Street 2:
Mailing Address - City:SWEDESBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08085
Mailing Address - Country:US
Mailing Address - Phone:856-467-9600
Mailing Address - Fax:856-467-1314
Practice Address - Street 1:1903 KINGS HIGHWAY
Practice Address - Street 2:
Practice Address - City:SWEDESBORO
Practice Address - State:NJ
Practice Address - Zip Code:08085
Practice Address - Country:US
Practice Address - Phone:856-467-9600
Practice Address - Fax:856-467-1314
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC003829111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6261205Medicaid
NJ722156Medicare ID - Type Unspecified