Provider Demographics
NPI:1548216153
Name:KUDEJ, EDWARD J (DC)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:J
Last Name:KUDEJ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:EDWARD
Other - Middle Name:J
Other - Last Name:KUDEJ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:555 BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-2635
Mailing Address - Country:US
Mailing Address - Phone:203-878-8803
Mailing Address - Fax:203-874-3945
Practice Address - Street 1:555 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-2635
Practice Address - Country:US
Practice Address - Phone:203-878-8803
Practice Address - Fax:203-874-3945
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT00764111N00000X
CT002136225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist