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General NPI Number Information
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NPI Number | 1194823757
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Entity Type | Individual
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Provider Name | PUJA WENTWORTH KAZMIERCZAK DC
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Gender | Female
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 12/16/2008
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Provider Practice Location Address
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Address Line | 148 MORRISVILLE SQUARE WAY
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City | MORRISVILLE
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State | NC
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Zip | 27560-5703
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Country | US
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Telephone | 207-680-0963
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Fax | 919-463-0431
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Provider Business Mailing Address
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Address Line | 8300 BRASS MILL LN APT 107
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City | RALEIGH
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State | NC
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Zip | 27617-8457
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Country | US
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Telephone | 207-680-0963
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Fax | 919-463-0431
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CR1559
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | NC3758
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License Number State | NC
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