Provider Demographics
NPI:1235695826
Name:JURCZYK, DANIEL PAUL (RN)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:PAUL
Last Name:JURCZYK
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 WHEELWRIGHT RD
Mailing Address - Street 2:
Mailing Address - City:BARRE
Mailing Address - State:MA
Mailing Address - Zip Code:01005-8882
Mailing Address - Country:US
Mailing Address - Phone:978-257-8135
Mailing Address - Fax:
Practice Address - Street 1:531 WHEELWRIGHT RD
Practice Address - Street 2:
Practice Address - City:BARRE
Practice Address - State:MA
Practice Address - Zip Code:01005-8882
Practice Address - Country:US
Practice Address - Phone:978-257-8135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-19
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2302146251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care