Provider Demographics
NPI:1396811485
Name:KINDZIERSKI, JOHN III (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:KINDZIERSKI
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:94 OLD SHORT HILLS RD
Mailing Address - Street 2:SUITE 3148
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-5672
Mailing Address - Country:US
Mailing Address - Phone:973-322-5669
Mailing Address - Fax:973-533-4492
Practice Address - Street 1:94 OLD SHORT HILLS RD
Practice Address - Street 2:SUITE 3148
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-5672
Practice Address - Country:US
Practice Address - Phone:973-322-5669
Practice Address - Fax:973-533-4492
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA033756207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0927031OtherAETNA
EP165OtherOXFORD
2243091OtherAETNA
1K3470OtherPHS
P67168352OtherMULTIPLAN
P67168352OtherMULTIPLAN
C63020Medicare UPIN