Provider Demographics
NPI:1275559346
Name:CZEKALSKI, JOAN A (CRNA)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:A
Last Name:CZEKALSKI
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 48078
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07101-4878
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:33 OVERLOOK RD
Practice Address - Street 2:STE 311
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-3570
Practice Address - Country:US
Practice Address - Phone:908-598-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO04118700367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ820494Medicare PIN
NJ820494DBFMedicare PIN