Healthcare Provider Details

I. General information

NPI: 1447273701
Provider Name (Legal Business Name): WOJCIECH A NAGORNY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 09/19/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 WESCOTT DR O.R.
FLEMINGTON NJ
08822-4603
US

IV. Provider business mailing address

PO BOX 622
FRANKLIN LAKES NJ
07417-0622
US

V. Phone/Fax

Practice location:
  • Phone: 908-788-6180
  • Fax: 908-788-6361
Mailing address:
  • Phone: 908-300-3700
  • Fax: 201-847-0059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number25MA07285600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: