Provider Demographics
NPI:1861065021
Name:HEYEL, DAVID CRAIG
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:CRAIG
Last Name:HEYEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:291 LAWRENCE CORNER RD
Mailing Address - Street 2:
Mailing Address - City:PITTSGROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:08318-2562
Mailing Address - Country:US
Mailing Address - Phone:856-469-1639
Mailing Address - Fax:
Practice Address - Street 1:291 LAWRENCE CORNER RD
Practice Address - Street 2:
Practice Address - City:PITTSGROVE
Practice Address - State:NJ
Practice Address - Zip Code:08318-2562
Practice Address - Country:US
Practice Address - Phone:856-469-1639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-23
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT000363002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer