Provider Demographics
NPI:1881574671
Name:BUCK, PAUL MICHAEL (LMT)
Entity type:Individual
Prefix:
First Name:PAUL MICHAEL
Middle Name:
Last Name:BUCK
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 NEWMAN ST
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-2644
Mailing Address - Country:US
Mailing Address - Phone:848-229-4725
Mailing Address - Fax:
Practice Address - Street 1:272 NEWMAN ST
Practice Address - Street 2:
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-2644
Practice Address - Country:US
Practice Address - Phone:848-229-4725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ18KT01528400225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist