Healthcare Provider Details

I. General information

NPI: 1578561460
Provider Name (Legal Business Name): STEPHEN A PISKER DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 06/14/2021
Certification Date: 06/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1903 KINGS HIGHWAY
SWEDESBORO NJ
08085
US

IV. Provider business mailing address

1903 KINGS HIGHWAY P.O BOX 217
SWEDESBORO NJ
08085
US

V. Phone/Fax

Practice location:
  • Phone: 856-467-9600
  • Fax: 856-467-1314
Mailing address:
  • Phone: 856-467-9600
  • Fax: 856-467-1314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberMC003829
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: