Healthcare Provider Details

I. General information

NPI: 1467416651
Provider Name (Legal Business Name): BRIAN KUZMA D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 AMBOY AVE
WOODBRIDGE NJ
07095-3050
US

IV. Provider business mailing address

545 AMBOY AVE
WOODBRIDGE NJ
07095-3050
US

V. Phone/Fax

Practice location:
  • Phone: 732-634-3040
  • Fax: 732-634-4533
Mailing address:
  • Phone: 732-634-3040
  • Fax: 732-634-4533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: