Provider Demographics
NPI:1609021112
Name:SZYMCZAK, SABRINA (LAC)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:
Last Name:SZYMCZAK
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:140 MALLINSON ST
Mailing Address - Street 2:
Mailing Address - City:ALLENDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07401-1918
Mailing Address - Country:US
Mailing Address - Phone:973-420-8836
Mailing Address - Fax:201-773-9701
Practice Address - Street 1:9 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:ELMWOOD PARK
Practice Address - State:NJ
Practice Address - Zip Code:07407-1529
Practice Address - Country:US
Practice Address - Phone:201-773-9700
Practice Address - Fax:201-773-9701
Is Sole Proprietor?:No
Enumeration Date:2008-11-25
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00038700171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist