1235105149 NPI number — MRS. BARBARA KATARZYNA PIECZURO M.D.

Table of content: MRS. BARBARA KATARZYNA PIECZURO M.D. (NPI 1235105149)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235105149 NPI number — MRS. BARBARA KATARZYNA PIECZURO M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PIECZURO
Provider First Name:
BARBARA
Provider Middle Name:
KATARZYNA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235105149
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/06/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
525 KIPP ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TEANECK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07666-1631
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-287-1067
Provider Business Mailing Address Fax Number:
201-287-1067

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17 SYLVAN ST
Provider Second Line Business Practice Location Address:
SUITE 203
Provider Business Practice Location Address City Name:
RUTHERFORD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07070-2037
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-935-3833
Provider Business Practice Location Address Fax Number:
201-935-0955
Provider Enumeration Date:
02/28/2006

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: 174400000X , with the licence number:  MA6857400 , 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)

  • Identifier: 7999909 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com