Provider Demographics
NPI:1033793732
Name:KULESZA, VERONICA (RD)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:KULESZA
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 ROCK HILL RD
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-2352
Mailing Address - Country:US
Mailing Address - Phone:973-557-7283
Mailing Address - Fax:
Practice Address - Street 1:160 ROCK HILL RD
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-2352
Practice Address - Country:US
Practice Address - Phone:973-557-7283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-08
Last Update Date:2021-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ86097093133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered