Provider Demographics
NPI:1679870299
Name:ENOCK, ADAM (SCD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:
Last Name:ENOCK
Suffix:
Gender:M
Credentials:SCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 E COUNTY LINE RD STE C
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-2082
Mailing Address - Country:US
Mailing Address - Phone:732-987-6590
Mailing Address - Fax:732-987-6591
Practice Address - Street 1:921 E COUNTY LINE RD STE C
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-2082
Practice Address - Country:US
Practice Address - Phone:732-987-6590
Practice Address - Fax:732-987-6591
Is Sole Proprietor?:No
Enumeration Date:2011-02-16
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YA00078800231H00000X
NJ25MG00121500237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1922305549OtherBUSINESS NPI