Healthcare Provider Details

I. General information

NPI: 1326093204
Provider Name (Legal Business Name): EDWARD F KUGLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 11/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

716 BROAD ST
CLIFTON NJ
07013-1645
US

IV. Provider business mailing address

145 ROUTE 46 W
WAYNE NJ
07470-6830
US

V. Phone/Fax

Practice location:
  • Phone: 973-777-1444
  • Fax: 973-777-4488
Mailing address:
  • Phone: 973-826-8283
  • Fax: 866-760-4568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number25MA05679100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: