Provider Demographics
NPI:1225159494
Name:JURKOWSKI, CLAIRE L (MD)
Entity Type:Individual
Prefix:DR
First Name:CLAIRE
Middle Name:L
Last Name:JURKOWSKI
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 1:10 WOODLAKE CT
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-8871
Mailing Address - Country:US
Mailing Address - Phone:609-440-0752
Mailing Address - Fax:609-714-1701
Practice Address - Street 1:10 WOODLAKE CT
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-8871
Practice Address - Country:US
Practice Address - Phone:609-440-0752
Practice Address - Fax:609-714-1701
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA52111207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ413538Q8FMedicare ID - Type Unspecified
NJF35513Medicare UPIN