Provider Demographics
NPI:1174627673
Name:MICHALSKI-PAFF, MAGDALENA (OD)
Entity Type:Individual
Prefix:
First Name:MAGDALENA
Middle Name:
Last Name:MICHALSKI-PAFF
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 AMBOY AVE
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07095-3159
Mailing Address - Country:US
Mailing Address - Phone:732-636-4222
Mailing Address - Fax:732-636-0737
Practice Address - Street 1:655 AMBOY AVE
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07095-3159
Practice Address - Country:US
Practice Address - Phone:732-636-4888
Practice Address - Fax:732-696-0737
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJOA00588700152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0059374Medicaid
NJV02057Medicare UPIN
NJ0059374Medicaid