Provider Demographics
NPI:1295756161
Name:CHARLES W. SAKENAS JR. D.C.
Entity type:Organization
Organization Name:CHARLES W. SAKENAS JR. D.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:W
Authorized Official - Last Name:SAKENAS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:609-465-8815
Mailing Address - Street 1:PO BOX 211
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-0211
Mailing Address - Country:US
Mailing Address - Phone:609-465-8815
Mailing Address - Fax:609-465-8813
Practice Address - Street 1:15 VILLAGE DR
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-1939
Practice Address - Country:US
Practice Address - Phone:609-465-8815
Practice Address - Fax:609-465-8813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNONE332B00000X
NJ38MC00235600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0664142000OtherKEYSTONE HEALTH PLAN EAST
NJ0664142000OtherAMERIHEALTH
NJ3854001Medicaid
NJP00207766OtherRAILROAD MEDICARE
NJ=========OtherHORIZON MERCY HEALTH PLAN
NJ3854001Medicaid
NJ=========OtherHORIZON BLUE SHIELD
NJP00207766OtherRAILROAD MEDICARE
NJ=========OtherHORIZON BLUE SHIELD
NJT99409Medicare UPIN