Provider Demographics
NPI:1235487737
Name:LUZZI, KRISTEN MARY (PA-C)
Entity Type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:MARY
Last Name:LUZZI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:515 N WOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036-4173
Mailing Address - Country:US
Mailing Address - Phone:908-925-8877
Mailing Address - Fax:908-925-4164
Practice Address - Street 1:515 N WOOD AVE
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-4173
Practice Address - Country:US
Practice Address - Phone:908-925-8877
Practice Address - Fax:908-925-4164
Is Sole Proprietor?:No
Enumeration Date:2012-08-15
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00290500363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical