Provider Demographics
NPI:1578604823
Name:SZYCH, JERRY RAYMOND (NP, DC, RN)
Entity type:Individual
Prefix:DR
First Name:JERRY
Middle Name:RAYMOND
Last Name:SZYCH
Suffix:
Gender:M
Credentials:NP, DC, RN
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:399 CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-1168
Mailing Address - Country:US
Mailing Address - Phone:908-252-0242
Mailing Address - Fax:908-252-0243
Practice Address - Street 1:1800 HIGHWAY 33 STE 105
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08690-1755
Practice Address - Country:US
Practice Address - Phone:609-981-7444
Practice Address - Fax:609-981-7046
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ38MC00411000111N00000X
NJ26NJ14902300363LF0000X
NY350690363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ408783Medicare ID - Type Unspecified