Provider Demographics
NPI:1841290053
Name:KURNICK, WARREN S (MD)
Entity type:Individual
Prefix:
First Name:WARREN
Middle Name:S
Last Name:KURNICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 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:609-871-0619
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA57620207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJB35367Medicare UPIN