Healthcare Provider Details

I. General information

NPI: 1235105149
Provider Name (Legal Business Name): BARBARA KATARZYNA PIECZURO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 05/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 SYLVAN ST SUITE 203
RUTHERFORD NJ
07070-2037
US

IV. Provider business mailing address

525 KIPP ST
TEANECK NJ
07666-1631
US

V. Phone/Fax

Practice location:
  • Phone: 201-935-3833
  • Fax: 201-935-0955
Mailing address:
  • Phone: 201-287-1067
  • Fax: 201-287-1067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMA6857400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: