Provider Demographics
NPI:1184707093
Name:SZABO, KEVIN P (DC)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:P
Last Name:SZABO
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 1:2000 ACADEMY DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-2831
Mailing Address - Country:US
Mailing Address - Phone:856-727-3536
Mailing Address - Fax:856-727-4703
Practice Address - Street 1:2000 ACADEMY DR
Practice Address - Street 2:SUITE 100
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-2831
Practice Address - Country:US
Practice Address - Phone:856-727-3536
Practice Address - Fax:856-727-4703
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC05098111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8282901Medicaid
NJU66084Medicare UPIN
NJ902512DT3Medicare ID - Type Unspecified