Provider Demographics
NPI:1184701153
Name:RUSSELL M. SINACK
Entity type:Organization
Organization Name:RUSSELL M. SINACK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:M
Authorized Official - Last Name:SINACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-505-3549
Mailing Address - Street 1:221 EDGEMERE DR
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-1161
Mailing Address - Country:US
Mailing Address - Phone:732-505-3549
Mailing Address - Fax:732-341-2306
Practice Address - Street 1:221 EDGEMERE DR
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-1161
Practice Address - Country:US
Practice Address - Phone:732-505-3549
Practice Address - Fax:732-341-2306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0756130001Medicare NSC