MEDICARE: EWA CZYZEWSKI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	25MA06757000	NJ

General Provider Information

NPI Number	:	1467473173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EWA CZYZEWSKI MD

Provider Business Mailing Address
First Line	:	515 N WOOD AVE
Second Line	:	SUITE 302
City	:	LINDEN
State	:	NJ
Zip	:	07036-4173
Country	:	US
Telephone Number	:	908-925-3300
Fax Number	:	908-925-4300

Provider Business Practice Location Address
First Line	:	515 N WOOD AVE
Second Line	:	SUITE 302
City	:	LINDEN
State	:	NJ
Zip	:	07036-4173
Country	:	US
Telephone Number	:	908-925-3300
Fax Number	:	908-925-4300

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	07/08/2007

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