Healthcare Provider Details

I. General information

NPI: 1407319072
Provider Name (Legal Business Name): DAVID PISARCIK DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2019
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 E LAUREL RD STE 3100-E
STRATFORD NJ
08084-1354
US

IV. Provider business mailing address

301 LIPPINCOTT DR STE 410
MARLTON NJ
08053-4197
US

V. Phone/Fax

Practice location:
  • Phone: 856-566-6409
  • Fax: 856-566-6333
Mailing address:
  • Phone: 856-566-6409
  • Fax: 856-566-6333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number25IB13183900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: