Provider Demographics
NPI:1811132426
Name:THE WASHLESKI CHIROPRACTIC CENTER, PC
Entity type:Organization
Organization Name:THE WASHLESKI CHIROPRACTIC CENTER, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:WASHLESKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:908-806-6171
Mailing Address - Street 1:179 STATE ROUTE 31
Mailing Address - Street 2:PLAZA 31
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-5743
Mailing Address - Country:US
Mailing Address - Phone:908-806-6171
Mailing Address - Fax:908-806-6433
Practice Address - Street 1:179 STATE ROUTE 31
Practice Address - Street 2:PLAZA 31
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-5743
Practice Address - Country:US
Practice Address - Phone:908-806-6171
Practice Address - Fax:908-806-6433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-10
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00006500171100000X
NJ38MC00299200111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJT77853Medicare UPIN