Provider Demographics
NPI:1851831291
Name:PAWLICK, ERIC RICHARD
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:RICHARD
Last Name:PAWLICK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 BLOOMINGDALE AVE
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-2523
Mailing Address - Country:US
Mailing Address - Phone:908-370-9859
Mailing Address - Fax:
Practice Address - Street 1:311 BLOOMINGDALE AVE
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-2523
Practice Address - Country:US
Practice Address - Phone:908-370-9859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-05
Last Update Date:2017-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer