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General NPI Number Information
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NPI Number | 1205866225
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Entity Type | Individual
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Provider Name | CHRISTOPHER J KACZMARSKI M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 01/28/2019
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Provider Practice Location Address
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Address Line | 160 N MIDLAND AVE FL 2
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City | NYACK
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State | NY
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Zip | 10960-1912
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Country | US
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Telephone | 845-348-7600
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Fax | 845-348-2536
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Provider Business Mailing Address
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Address Line | 305 ORCHARD AVE
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City | LANGHORNE
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State | PA
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Zip | 19047-3159
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Country | US
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Telephone | 609-760-3014
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD063400L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 148896
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License Number State | NY
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