Provider Demographics
NPI:1700854254
Name:PSOLKA, BARBARA J (RN, DC, NP-C)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:J
Last Name:PSOLKA
Suffix:
Gender:F
Credentials:RN, DC, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:572 PASCACK RD
Mailing Address - Street 2:
Mailing Address - City:TOWNSHIP OF WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07676-4346
Mailing Address - Country:US
Mailing Address - Phone:239-537-9101
Mailing Address - Fax:201-664-1463
Practice Address - Street 1:8 JORDAN AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-3386
Practice Address - Country:US
Practice Address - Phone:201-432-5744
Practice Address - Fax:201-432-2720
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCHO5011111N00000X
NJ38MC00683700111N00000X
NJ26NO06886900163WP2201X
FLRN1632542163WP2201X
NJ26NJ00467300363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No111N00000XChiropractic ProvidersChiropractor
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL70823Medicare ID - Type Unspecified
FLV-1885Medicare UPIN