Provider Demographics
NPI:1760467294
Name:ADAMCZYK, ROBERT K (PA C)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:K
Last Name:ADAMCZYK
Suffix:
Gender:
Credentials:PA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 CRANBROOK RD
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-6328
Mailing Address - Country:US
Mailing Address - Phone:410-991-6280
Mailing Address - Fax:
Practice Address - Street 1:101 E UNION AVE
Practice Address - Street 2:
Practice Address - City:BOUND BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08805-1765
Practice Address - Country:US
Practice Address - Phone:732-560-0490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00016400207Q00000X, 363A00000X
MDC0002239363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine