Provider Demographics
NPI:1629397146
Name:TRZESNIOWSKI, AGNIESZKA (RPH)
Entity Type:Individual
Prefix:
First Name:AGNIESZKA
Middle Name:
Last Name:TRZESNIOWSKI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 UPPER SAREPTA RD
Mailing Address - Street 2:
Mailing Address - City:BELVIDERE
Mailing Address - State:NJ
Mailing Address - Zip Code:07823-2630
Mailing Address - Country:US
Mailing Address - Phone:908-475-5747
Mailing Address - Fax:
Practice Address - Street 1:2 UPPER SAREPTA RD
Practice Address - Street 2:
Practice Address - City:BELVIDERE
Practice Address - State:NJ
Practice Address - Zip Code:07823-2630
Practice Address - Country:US
Practice Address - Phone:908-475-5747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-24
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02673400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist