Provider Demographics
NPI:1659671881
Name:KULIKOWSKI, JANICE T (RD)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:T
Last Name:KULIKOWSKI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 BORTHWICK AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-4174
Mailing Address - Country:US
Mailing Address - Phone:603-436-6115
Mailing Address - Fax:603-433-5567
Practice Address - Street 1:330 BORTHWICK AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-4174
Practice Address - Country:US
Practice Address - Phone:603-436-6115
Practice Address - Fax:603-433-5567
Is Sole Proprietor?:No
Enumeration Date:2010-10-21
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH314133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHP00922204OtherRAILROAD MEDICARE
NH001969501Medicare PIN