Evanchik, Tina Marie

Evanchik, Tina Marie is an individual health care provider with primary practice located at 725 Airport Rd , Lakewood NJ 08701-5968. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Evanchik, Tina Marie can be contacted via phone (732) 367-2665.

Contact Information

Primary practice address
725 Airport Rd Lakewood NJ 08701-5968
Phone: (732) 367-2665
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1760912265
LBN Legal business name Evanchik, Tina Marie
Credentials Bachelor of Arts (BA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2017
Last updated Jun 15th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760912265 NPPES
New Jersey MEDICAID 0029807

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