=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346227220
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROBERT A WASHLESKI DC, LAC.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/30/2005
-----------------------------------------------------
Last Update Date | 05/15/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4 WALTER E FORAN BLVD STE 304
-----------------------------------------------------
City | FLEMINGTON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08822
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-806-6171
-----------------------------------------------------
Fax | 908-806-6433
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4 WALTER E FORAN BLVD STE 304
-----------------------------------------------------
City | FLEMINGTON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08822-4668
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-806-6171
-----------------------------------------------------
Fax | 908-806-6433
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | 25MZ00006500
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 111NX0800X
-----------------------------------------------------
Taxonomy Name | Orthopedic Chiropractor
-----------------------------------------------------
License Number | 38MC00299200
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------