1225086911 NPI number — MRS. IRENA BADZELEWICZ DDS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225086911 NPI number — MRS. IRENA BADZELEWICZ DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BADZELEWICZ
Provider First Name:
IRENA
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HARTL
Provider Other First Name:
IRENE
Provider Other Middle Name:
B
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1225086911
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4 HARWICH CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCOTCH PLAINS
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07076-3162
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-388-7627
Provider Business Mailing Address Fax Number:
732-388-4651

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1961 MORRIS AVE
Provider Second Line Business Practice Location Address:
SUITE B-7
Provider Business Practice Location Address City Name:
UNION
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07083-3531
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-810-0076
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/04/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  22DI01953300 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)