Provider Demographics
NPI:1205994928
Name:WARREN S KURNICK M D DERMATOLOGY GROUP P A
Entity type:Organization
Organization Name:WARREN S KURNICK M D DERMATOLOGY GROUP P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:S
Authorized Official - Last Name:KURNICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-871-9500
Mailing Address - Street 1:220 SUNSET RD STE 2C
Mailing Address - Street 2:
Mailing Address - City:WILLINGBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08046-1126
Mailing Address - Country:US
Mailing Address - Phone:609-871-9500
Mailing Address - Fax:609-871-0619
Practice Address - Street 1:220 SUNSET RD STE 2C
Practice Address - Street 2:
Practice Address - City:WILLINGBORO
Practice Address - State:NJ
Practice Address - Zip Code:08046-1126
Practice Address - Country:US
Practice Address - Phone:609-871-9500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA057620207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty