Provider Demographics
NPI:1578526711
Name:KURTZER, MARIA ALENA (APRN)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ALENA
Last Name:KURTZER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:DOCENA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:PO BOX 416457
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-6457
Mailing Address - Country:US
Mailing Address - Phone:844-362-1735
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:215 NORTH AVE W
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-1428
Practice Address - Country:US
Practice Address - Phone:908-232-4321
Practice Address - Fax:908-232-7788
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00041500364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ077232Medicare ID - Type Unspecified