Provider Demographics
NPI:1801031075
Name:SAWICKI, JAMES JAY JR (ATC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:JAY
Last Name:SAWICKI
Suffix:JR
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 5TH AVE
Mailing Address - Street 2:UNIT #9
Mailing Address - City:BELMAR
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-2073
Mailing Address - Country:US
Mailing Address - Phone:609-209-5023
Mailing Address - Fax:
Practice Address - Street 1:117 EVERGREEN RD
Practice Address - Street 2:
Practice Address - City:NEW EGYPT
Practice Address - State:NJ
Practice Address - Zip Code:08533-1207
Practice Address - Country:US
Practice Address - Phone:609-758-6800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT001072002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer