Provider Demographics
NPI:1497262638
Name:CZEKALSKI, BOZENA (APN)
Entity Type:Individual
Prefix:
First Name:BOZENA
Middle Name:
Last Name:CZEKALSKI
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1216 ENGLEMERE BLVD
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08757-1527
Mailing Address - Country:US
Mailing Address - Phone:732-600-3430
Mailing Address - Fax:
Practice Address - Street 1:1216 ENGLEMERE BLVD
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08757-1527
Practice Address - Country:US
Practice Address - Phone:732-600-3430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-09
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00782000363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner