Provider Demographics
NPI:1639639487
Name:KUSHNER, CAROLYN J (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:J
Last Name:KUSHNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:636 MORRIS TPKE STE 2H
Mailing Address - Street 2:
Mailing Address - City:SHORT HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07078-2608
Mailing Address - Country:US
Mailing Address - Phone:973-232-6245
Mailing Address - Fax:973-232-6247
Practice Address - Street 1:2200 STATE ROUTE 10
Practice Address - Street 2:SUITE 106
Practice Address - City:MORRIS PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07950
Practice Address - Country:US
Practice Address - Phone:973-232-6245
Practice Address - Fax:973-232-6247
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-20
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ25MA11857500207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program