MEDICARE: MS. KRISTEN MARY LUZZI P.A.-C.

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	363AM0700X	Medical Physician Assistant	25MP00290500	NJ

General Provider Information

NPI Number	:	1235487737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KRISTEN MARY LUZZI P.A.-C.

Provider Business Mailing Address
First Line	:	515 N WOOD AVE
Second Line	:
City	:	LINDEN
State	:	NJ
Zip	:	07036-4173
Country	:	US
Telephone Number	:	908-925-8877
Fax Number	:	908-925-4164

Provider Business Practice Location Address
First Line	:	515 N WOOD AVE
Second Line	:
City	:	LINDEN
State	:	NJ
Zip	:	07036-4173
Country	:	US
Telephone Number	:	908-925-8877
Fax Number	:	908-925-4164

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2012
Last Update Date	:	10/28/2014

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Directions to “ MS. KRISTEN MARY LUZZI P.A.-C.” Practice Location

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