| Organization Name: | PHYSICIAN SHOCKWAVER THERAPY |
| NPI Number: | 1952316226 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAVID HARRIS ZUCKERMAN (MEDICAL DIRECTOR) |
| Mailing Address: | 13 West Ave Woodstown |
| State: | NJ US |
| Postal Code: | 080980145 |
| Phone Number: | 8567698270 |
| Fax Number: | 8567698275 |
| NPI Enumeration Date: | 07/29/2006 |
| NPI Last Update Date: | 08/21/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |