Kenneth T. Cieslak, D.C.
Individual provider Active NPI Athletic Trainer · Bogota, NJ
NPI 1164539375 · NPPES record last updated Sep 11, 2025
Key facts
- NPI
- 1164539375
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 25MT00033300 (NJ)
- Practice address
- 61 E Main St
Bogota, NJ 07603-1369 - Phone
- (201) 390-1816
- NPI assigned
- Aug 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MT00033300 | NJ | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Garden State Spine and Rehabilitation | Chiropractor | Current |
Accepting new patients |
| Ferraro Spine & Rehabilitation, PC | Chiropractor | Current |
Accepting new patients |
| VG Physical Therapy | Current |
Accepting new patients |
Locations
77 Schanck Rd
Ste B-17
Freehold, NJ 07728
Phone (201) 871-4000
230 Midland Ave
Saddle Brook, NJ 07663
Phone (973) 478-2122
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 38MC00490000 | NJ | |
| Athletic Trainer | 2255A2300X | 25MT00033300 | NJ | Yes |
Addresses
Primary practice location
61 E Main St
Bogota, NJ 07603-1369
Mailing address
12 Osborne Ter
Wayne, NJ 07470-4362
Phone (973) 709-0574
Other providers in Bogota, NJ
- Alejandra Irina Brito
- Ashley Brito
- Gabrielle A Carpenter
- Ariel Castro
- Children'S Aid and Family Services, Inc.
- Alyssa Colton
- Daniel E Golden DC PA
- Kristine Dimitui
- Rosalyn Feinman
- Luis Fernandez
All providers in Bogota, NJ · Athletic Trainer in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.