Provider Demographics
NPI:1619557162
Name:KWIATKOWSKI, BIELKA (PHLEBOTOMY TECH)
Entity Type:Individual
Prefix:
First Name:BIELKA
Middle Name:
Last Name:KWIATKOWSKI
Suffix:
Gender:F
Credentials:PHLEBOTOMY TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 CAPITOL REEF RD
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-9005
Mailing Address - Country:US
Mailing Address - Phone:732-351-0024
Mailing Address - Fax:
Practice Address - Street 1:14 CAPITOL REEF RD
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-9005
Practice Address - Country:US
Practice Address - Phone:732-351-0024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-09
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD200137R17246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty