Provider Demographics
NPI:1841389863
Name:KAIRYS, MARIE Z (MD)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:Z
Last Name:KAIRYS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 FEDERAL ST STE 200
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1088
Mailing Address - Country:US
Mailing Address - Phone:848-288-6935
Mailing Address - Fax:732-790-0107
Practice Address - Street 1:950 S CHESTER AVE
Practice Address - Street 2:
Practice Address - City:DELRAN
Practice Address - State:NJ
Practice Address - Zip Code:08075-1271
Practice Address - Country:US
Practice Address - Phone:856-536-1515
Practice Address - Fax:856-536-1981
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD042523L207Q00000X
NJ25MA06202800207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0531160OtherAETNA
080102247OtherRAIL ROAD MEDICARE
19327OtherUNIVERSITY HEALTHPLAN
NJ6650708Medicaid
0816759000OtherAMERIHEALTH, KEYSTONE, IBC
1080883OtherHORIZON NJ HEALTH
1435080OtherUNITED HEALTHCARE
080102247OtherRAIL ROAD MEDICARE
NJ791541 DK6Medicare PIN