Healthcare Provider Details

I. General information

NPI: 1225360217
Provider Name (Legal Business Name): JARROD MICHAEL KUCHARSKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2010
Last Update Date: 05/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 POCONO RD
DENVILLE NJ
07834-2954
US

IV. Provider business mailing address

1034 BLOOMFIELD ST APARTMENT 1
HOBOKEN NJ
07030-5220
US

V. Phone/Fax

Practice location:
  • Phone: 973-625-6000
  • Fax:
Mailing address:
  • Phone: 201-238-2606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA08698800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: