Provider Demographics
NPI:1659650737
Name:GENACK, ESTHER (PA)
Entity type:Individual
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First Name:ESTHER
Middle Name:
Last Name:GENACK
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Gender:F
Credentials:PA
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Mailing Address - Street 1:655 SHREWSBURY AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4179
Mailing Address - Country:US
Mailing Address - Phone:732-345-1180
Mailing Address - Fax:732-530-4476
Practice Address - Street 1:530 LAKEHURST RD STE 101
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-8063
Practice Address - Country:US
Practice Address - Phone:732-349-8454
Practice Address - Fax:732-341-0259
Is Sole Proprietor?:No
Enumeration Date:2011-08-08
Last Update Date:2025-07-21
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Provider Licenses
StateLicense IDTaxonomies
NJ25MP00262000363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant