Provider Demographics
NPI:1598904930
Name:GRACE ANNE KUZARA DPM
Entity Type:Organization
Organization Name:GRACE ANNE KUZARA DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:A
Authorized Official - Last Name:KUZARA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:856-423-7700
Mailing Address - Street 1:65 LICCIARDELLO DR
Mailing Address - Street 2:
Mailing Address - City:SWEDESBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08085-1819
Mailing Address - Country:US
Mailing Address - Phone:856-423-7700
Mailing Address - Fax:856-423-0823
Practice Address - Street 1:3200 BENSALEM BLVD
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-1956
Practice Address - Country:US
Practice Address - Phone:856-423-7700
Practice Address - Fax:856-423-0823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty