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General NPI Number Information
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NPI Number | 1851202311
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Entity Type | Individual
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Provider Name | JUSTYNA ANETA SUROWANIEC
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Gender | Female
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Dates
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Enumeration Date | 09/14/2026
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Last Update Date | 09/14/2026
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Provider Practice Location Address
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Address Line | 350 BOULEVARD
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City | PASSAIC
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State | NJ
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Zip | 07055-2840
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Country | US
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Telephone | 973-365-4300
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Fax |
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Provider Business Mailing Address
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Address Line | 32 GARDEN CT N
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City | GARFIELD
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State | NJ
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Zip | 07026-2312
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Country | US
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Telephone | 201-270-7225
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ15559800
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License Number State | NJ
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