Provider Demographics
NPI:1821362823
Name:KUZMICKI, ANGELA J (RN)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:J
Last Name:KUZMICKI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10308-3218
Mailing Address - Country:US
Mailing Address - Phone:718-982-4701
Mailing Address - Fax:718-227-5397
Practice Address - Street 1:225 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10308-3218
Practice Address - Country:US
Practice Address - Phone:718-982-4701
Practice Address - Fax:718-227-5397
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-08
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY163862-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool