Healthcare Provider Details

I. General information

NPI: 1902027121
Provider Name (Legal Business Name): SUE KUJALOWICZ APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 02/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1935 AXTON AVE
UNION NJ
07083
US

IV. Provider business mailing address

1935 AXTON AVENUE
UNION NJ
07083
US

V. Phone/Fax

Practice location:
  • Phone: 908-688-4227
  • Fax:
Mailing address:
  • Phone: 908-688-4227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number26NC05831400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: