Provider Demographics
NPI:1942437561
Name:PENSAK, MICHAEL J (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:PENSAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 LAKEHURST RD
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-8063
Mailing Address - Country:US
Mailing Address - Phone:732-349-8454
Mailing Address - Fax:732-349-4713
Practice Address - Street 1:530 LAKEHURST RD
Practice Address - Street 2:1ST FLOOR
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-8063
Practice Address - Country:US
Practice Address - Phone:732-349-8454
Practice Address - Fax:732-349-4713
Is Sole Proprietor?:No
Enumeration Date:2009-06-22
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09846100207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery