Healthcare Provider Details

I. General information

NPI: 1760467294
Provider Name (Legal Business Name): ROBERT K ADAMCZYK PA C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2005
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E UNION AVE
BOUND BROOK NJ
08805-1765
US

IV. Provider business mailing address

1105 CRANBROOK RD
UNION NJ
07083-6328
US

V. Phone/Fax

Practice location:
  • Phone: 732-560-0490
  • Fax:
Mailing address:
  • Phone: 410-991-6280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MP00016400
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC0002239
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number25MP00016400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: