Provider Demographics
NPI:1235105149
Name:PIECZURO, BARBARA KATARZYNA (MD)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:KATARZYNA
Last Name:PIECZURO
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 1:525 KIPP ST
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-1631
Mailing Address - Country:US
Mailing Address - Phone:201-287-1067
Mailing Address - Fax:201-287-1067
Practice Address - Street 1:17 SYLVAN ST
Practice Address - Street 2:SUITE 203
Practice Address - City:RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07070-2037
Practice Address - Country:US
Practice Address - Phone:201-935-3833
Practice Address - Fax:201-935-0955
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-28
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA6857400174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7999909Medicaid