| Doctor Name: | GARY J MASCILAK |
| NPI Number: | 1881680742 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | 38MC00455100 |
| Business Practice Address: | 540 Lafayette Rd Route 15 So Suite B Sparta, NJ - 07871 |
| Business Phone Number: | 9739408680 |
| Business Fax Number: | 9739408634 |
| Mailing Address: | 21 Lafayette Rd, Suite C SPARTA |
| State: | NJ |
| Postal Code: | 07871 |
| Phone Number: | 9737290291 |
| Fax Number: | 9737296710 |
| NPI Enumeration Date: | 09/26/2005 |
| NPI Last Update Date: | 07/22/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 111N00000X |
| License Number: | 38MC00455100 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NJ |
| Taxonomy Type: | Chiropractic Providers |
| Taxonomy Classification: | Chiropractor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |