Provider Demographics
NPI:1245479369
Name:HAIKEN, WOODY (NCTMB)
Entity type:Individual
Prefix:
First Name:WOODY
Middle Name:
Last Name:HAIKEN
Suffix:
Gender:M
Credentials:NCTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 US HIGHWAY 9
Mailing Address - Street 2:SUITE D-1
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-8270
Mailing Address - Country:US
Mailing Address - Phone:732-662-4026
Mailing Address - Fax:
Practice Address - Street 1:203 US HIGHWAY 9
Practice Address - Street 2:SUITE D-1
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-8270
Practice Address - Country:US
Practice Address - Phone:732-662-4026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-12
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist