Healthcare Provider Details

I. General information

NPI: 1942451976
Provider Name (Legal Business Name): HELEN TERESA KUZNICKI R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2008
Last Update Date: 10/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 FAIRVIEW AVE APT. 522
TUCKAHOE NY
10707-4151
US

IV. Provider business mailing address

21 FAIRVIEW AVE APT. 522
TUCKAHOE NY
10707-4151
US

V. Phone/Fax

Practice location:
  • Phone: 914-319-9288
  • Fax:
Mailing address:
  • Phone: 914-319-9288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number427613-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: