Provider Demographics
NPI:1801939400
Name:SWANIK, CHARLES BUZ (PHD, ATC)
Entity type:Individual
Prefix:PROF
First Name:CHARLES
Middle Name:BUZ
Last Name:SWANIK
Suffix:
Gender:M
Credentials:PHD, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 MANOR CT
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-1649
Mailing Address - Country:US
Mailing Address - Phone:856-266-7221
Mailing Address - Fax:
Practice Address - Street 1:547 SOUTH COLLEGE AVENUE
Practice Address - Street 2:151 HPL, C O FRED RUST ARENA
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19716
Practice Address - Country:US
Practice Address - Phone:302-831-2306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ3-00002862255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer