Provider Demographics
NPI:1174615660
Name:MALGORZATA KUZA
Entity type:Organization
Organization Name:MALGORZATA KUZA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MALGORZATA
Authorized Official - Middle Name:W
Authorized Official - Last Name:KUZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-738-8837
Mailing Address - Street 1:225 MAY ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-3266
Mailing Address - Country:US
Mailing Address - Phone:732-738-8837
Mailing Address - Fax:732-738-6949
Practice Address - Street 1:225 MAY ST
Practice Address - Street 2:SUITE B
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-3266
Practice Address - Country:US
Practice Address - Phone:732-738-8837
Practice Address - Fax:732-738-6949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA49533261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE23799Medicare UPIN