Provider Demographics
NPI:1033420716
Name:KULICH, JUDITH E
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:E
Last Name:KULICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 E SHAWNEE TRL
Mailing Address - Street 2:
Mailing Address - City:WHARTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07885-2938
Mailing Address - Country:US
Mailing Address - Phone:973-663-0473
Mailing Address - Fax:
Practice Address - Street 1:28 E SHAWNEE TRL
Practice Address - Street 2:
Practice Address - City:WHARTON
Practice Address - State:NJ
Practice Address - Zip Code:07885-2938
Practice Address - Country:US
Practice Address - Phone:973-663-0473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-28
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist