Provider Demographics
NPI:1164514063
Name:CIECHANOWSKA, MARGARET (MD)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:
Last Name:CIECHANOWSKA
Suffix:
Gender:F
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:PO BOX 8275
Mailing Address - Street 2:
Mailing Address - City:GLEN RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07028-9998
Mailing Address - Country:US
Mailing Address - Phone:201-714-4668
Mailing Address - Fax:201-714-9881
Practice Address - Street 1:142 PALISADE AVENUE
Practice Address - Street 2:SUITE 216
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306
Practice Address - Country:US
Practice Address - Phone:201-714-4668
Practice Address - Fax:201-714-9881
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05198200207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0324302Medicaid
NJ536457Medicare ID - Type Unspecified
NJ0324302Medicaid