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General NPI Number Information
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NPI Number | 1316577398
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Entity Type | Individual
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Provider Name | IZABELA URBANIEC PA
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Gender | Female
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Dates
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Enumeration Date | 01/18/2020
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Last Update Date | 01/18/2020
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Provider Practice Location Address
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Address Line | 328 W SAINT GEORGES AVE
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City | LINDEN
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State | NJ
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Zip | 07036-5638
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Country | US
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Telephone | 908-925-7519
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Fax | 908-925-2842
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Provider Business Mailing Address
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Address Line | 47 VIOLET PL
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City | EDISON
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State | NJ
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Zip | 08817-4543
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Country | US
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Telephone | 732-801-9171
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP00546300
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License Number State | NJ
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