Provider Demographics
NPI:1831361088
Name:REDZIO, URSZULA (DDS)
Entity type:Individual
Prefix:DR
First Name:URSZULA
Middle Name:
Last Name:REDZIO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 WESSINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:GARFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07026-2727
Mailing Address - Country:US
Mailing Address - Phone:973-772-0024
Mailing Address - Fax:
Practice Address - Street 1:6913 FOREST AVE
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-4457
Practice Address - Country:US
Practice Address - Phone:718-417-8453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-27
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0532391223G0001X
NJ22DI023334001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice