Provider Demographics
NPI:1942410873
Name:HREHOWSIK, RYAN MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:MICHAEL
Last Name:HREHOWSIK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:776 AMBOY AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-3224
Mailing Address - Country:US
Mailing Address - Phone:732-661-0330
Mailing Address - Fax:732-661-1366
Practice Address - Street 1:776 AMBOY AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-3224
Practice Address - Country:US
Practice Address - Phone:732-661-0330
Practice Address - Fax:732-661-1366
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00561200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ223823723OtherTAX ID
NJP2720518OtherOXFORD PROVIDER ID
NJU93013Medicare UPIN
NJ223823723OtherTAX ID