Provider Demographics
NPI:1013051697
Name:KAWCZYNSKI, SUSAN (RN)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:
Last Name:KAWCZYNSKI
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 1:31 CRANFORD TER
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-3454
Mailing Address - Country:US
Mailing Address - Phone:908-276-4168
Mailing Address - Fax:
Practice Address - Street 1:108 ALDEN ST
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-2131
Practice Address - Country:US
Practice Address - Phone:908-497-3987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ088009163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ088009OtherREGISTERED NURSE LICENSE