Healthcare Provider Details

I. General information

NPI: 1730180555
Provider Name (Legal Business Name): BRENDA R KURNIK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 07/01/2023
Certification Date: 07/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 SHEPPARD ROAD
VOORHEES NJ
08043
US

IV. Provider business mailing address

56 PALMER DR
MOORESTOWN NJ
08057-3882
US

V. Phone/Fax

Practice location:
  • Phone: 856-424-7390
  • Fax: 844-295-1371
Mailing address:
  • Phone: 856-905-8943
  • Fax: 856-988-8069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number25MA04657800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: