Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. EDWARD CHARLES SHADIACK JR., D.O.
Active Sole ProprietorDR. EDWARD CHARLES SHADIACK JR., D.O. is a Family Medicine healthcare provider located in SEASIDE PARK, New Jersey. NPI 1245339779 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · SEASIDE PARK, NJ
Registration Details
- NPI Number
- 1245339779
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 21, 2006 (19.86996155502 yrs)
- Last Updated
- Jul 8, 2007
- License
-
MB41240 (NJ)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1200 NE CENTRAL AVE # 02SEASIDE PARK, NJ, 087521306Browse NJ providers · Browse ZIP 08752
- Phone
- 7328304884
- Primary Specialty
-
Family Medicine
207Q00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.