Provider Demographics
NPI:1124188792
Name:KIRZNER, HOWARD LAWRENCE (MD)
Entity Type:Individual
Prefix:MR
First Name:HOWARD
Middle Name:LAWRENCE
Last Name:KIRZNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 HUBBARD SCHOOL ROAD
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446
Mailing Address - Country:US
Mailing Address - Phone:201-825-1507
Mailing Address - Fax:
Practice Address - Street 1:699 TEANECK ROAD
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4244
Practice Address - Country:US
Practice Address - Phone:201-836-2500
Practice Address - Fax:201-836-0083
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA045785002085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0014109Medicaid
536033R6FMedicare ID - Type Unspecified
NJ0014109Medicaid