Provider Demographics
NPI:1235580507
Name:KIELCZEWSKI, PAWEL (RRT)
Entity Type:Individual
Prefix:
First Name:PAWEL
Middle Name:
Last Name:KIELCZEWSKI
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 WOODSIDE LN
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-3085
Mailing Address - Country:US
Mailing Address - Phone:917-709-0930
Mailing Address - Fax:
Practice Address - Street 1:333 WOODSIDE LN
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-3085
Practice Address - Country:US
Practice Address - Phone:917-709-0930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-28
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ43ZA00561900227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered