Dr Edward Charles Shadiack Jr, DO is a
Family Medicine physician based in Seaside Park, New Jersey. Dr Edward Charles Shadiack Jr is licensed to practice in New Jersey (license number MB41240) and his current practice location is 1200 Ne Central Ave # 02, Seaside Park, New Jersey. He can be reached at his office (for appointments etc.) via phone at
(732) 830-4884.
NPI number for Dr Edward Charles Shadiack Jr is 1245339779 and his current mailing address is 1200 Ne Central Ave # 02, Seaside Park, New Jersey. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1245339779.
Physician's Profile
| Full Name | Dr Edward Charles Shadiack Jr |
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| Gender | Male |
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| Speciality | Family Medicine |
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| Location | 1200 Ne Central Ave # 02, Seaside Park, New Jersey |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1245339779
- Provider Enumeration Date: 09/21/2006
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Dr Edward Charles Shadiack Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1245339779 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | MB41240 (New Jersey) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Edward Charles Shadiack Jr is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Edward Charles Shadiack Jr, DO
1200 Ne Central Ave # 02,
Seaside Park, NJ 08752-1306
Ph: (732) 830-4884 | Dr Edward Charles Shadiack Jr, DO
1200 Ne Central Ave # 02,
Seaside Park, NJ 08752-1306
Ph: (732) 830-4884 |
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