Provider Demographics
NPI:1609877877
Name:RAJECKAS, ANDREW J (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:J
Last Name:RAJECKAS
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 1:762 STATE HWY NO 15
Mailing Address - Street 2:
Mailing Address - City:LAKE HOPATCONG
Mailing Address - State:NJ
Mailing Address - Zip Code:07438
Mailing Address - Country:US
Mailing Address - Phone:973-663-3002
Mailing Address - Fax:973-663-4894
Practice Address - Street 1:762 STATE HWY 15
Practice Address - Street 2:
Practice Address - City:LAKE HOPATCONG
Practice Address - State:NJ
Practice Address - Zip Code:07438
Practice Address - Country:US
Practice Address - Phone:973-663-3002
Practice Address - Fax:973-663-4894
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00274100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5165709Medicaid
NJ5165709Medicaid