Individual
SUSAN H PENCZAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
2041 STATE ROUTE 35, WALL TOWNSHIP, NJ 07719-3539
(732) 974-7022
(732) 974-7023
Mailing address
2041 STATE ROUTE 35, WALL TOWNSHIP, NJ 07719-3539
(732) 974-7022
(732) 974-7023
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38MC00554100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2273901000
AMERIHEALTH INDIV. HMO ID
—
01
—
2281138000
AMERIHEALTH PRACTIC HMO I
—
01
—
P3271421
OXFORD
—
Enumeration date
07/05/2006
Last updated
02/08/2008
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