Provider Demographics
NPI:1861740540
Name:SINACK, RUSSELL (RRT)
Entity type:Individual
Prefix:
First Name:RUSSELL
Middle Name:
Last Name:SINACK
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 EDGEMERE DR
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-1161
Mailing Address - Country:US
Mailing Address - Phone:732-505-8277
Mailing Address - Fax:732-341-2306
Practice Address - Street 1:221 EDGEMERE DR
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-1161
Practice Address - Country:US
Practice Address - Phone:732-505-8277
Practice Address - Fax:732-341-2306
Is Sole Proprietor?:No
Enumeration Date:2012-08-28
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ43ZA00502400227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered