Healthcare Provider Details

I. General information

NPI: 1295756161
Provider Name (Legal Business Name): CHARLES W. SAKENAS JR. D.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2006
Last Update Date: 08/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 VILLAGE DR
CAPE MAY COURT HOUSE NJ
08210-1939
US

IV. Provider business mailing address

PO BOX 211
CAPE MAY COURT HOUSE NJ
08210-0211
US

V. Phone/Fax

Practice location:
  • Phone: 609-465-8815
  • Fax: 609-465-8813
Mailing address:
  • Phone: 609-465-8815
  • Fax: 609-465-8813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00235600
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberNONE
License Number StateNJ

VIII. Authorized Official

Name: CHARLES W. SAKENAS JR.
Title or Position: OWNER
Credential: D.C.
Phone: 609-465-8815