Provider Demographics
NPI:1053835686
Name:MUZHETSKAYA, EVGENIYA (NP)
Entity Type:Individual
Prefix:
First Name:EVGENIYA
Middle Name:
Last Name:MUZHETSKAYA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1361 HAMILTON ST
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-3345
Mailing Address - Country:US
Mailing Address - Phone:347-422-3075
Mailing Address - Fax:
Practice Address - Street 1:1120 MEDICAL PLAZA DR STE 150
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-3250
Practice Address - Country:US
Practice Address - Phone:347-422-3075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-26
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP135882363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care