MEDICARE: STEPHEN A. NURKIEWICZ, MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1124320627
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPHEN A. NURKIEWICZ, MD

Provider Business Mailing Address
First Line	:	858 S WHITE HORSE PIKE
Second Line	:
City	:	HAMMONTON
State	:	NJ
Zip	:	08037-2031
Country	:	US
Telephone Number	:	609-561-2345
Fax Number	:	609-561-8969

Provider Business Practice Location Address
First Line	:	858 S WHITE HORSE PIKE
Second Line	:
City	:	HAMMONTON
State	:	NJ
Zip	:	08037-2031
Country	:	US
Telephone Number	:	609-561-2345
Fax Number	:	609-561-8969

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. MARIAN NURKIEWICZ
Credential	:
Telephone Number	:	609-561-2345

Provider Enumeration Date	:	12/03/2010
Last Update Date	:	12/03/2010

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