Provider Demographics
NPI:1851313860
Name:SAKENAS, CHARLES W JR (DC)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:W
Last Name:SAKENAS
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 211
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-0211
Mailing Address - Country:US
Mailing Address - Phone:609-465-8815
Mailing Address - Fax:609-465-8813
Practice Address - Street 1:15 VILLAGE DR
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-1939
Practice Address - Country:US
Practice Address - Phone:609-465-8815
Practice Address - Fax:609-465-8813
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00235600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0099443000OtherAMERIHEALTH
NJP00207766OtherRAILROAD MEDICARE
NJ331284OtherAMERIHEALTH ADMINISTRATOR
NJ0099443000OtherKEYSTONE HEALTH PLAN EAST
NJ3854001Medicaid
NJ5372240001Medicare NSC
NJP00207766Medicare PIN
NJT99409Medicare UPIN
NJ3854001Medicaid