Provider Demographics
NPI:1760429351
Name:SALUCK, SHARI L (DC)
Entity Type:Individual
Prefix:
First Name:SHARI
Middle Name:L
Last Name:SALUCK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 A HADDON AVE.
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:NJ
Mailing Address - Zip Code:08108
Mailing Address - Country:US
Mailing Address - Phone:856-833-9390
Mailing Address - Fax:
Practice Address - Street 1:340 A HADDON AVE.
Practice Address - Street 2:
Practice Address - City:WESTMONT
Practice Address - State:NJ
Practice Address - Zip Code:08108
Practice Address - Country:US
Practice Address - Phone:856-833-9390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-01
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC004990111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
050659Medicare ID - Type Unspecified