MEDICARE: MRS. AGNIESZKA M KWAPNIEWSKI M.D

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	207R00000X	Internal Medicine Physician	25MA07529400	NJ

General Provider Information

NPI Number	:	1528007457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AGNIESZKA M KWAPNIEWSKI M.D

Provider Business Mailing Address
First Line	:	312 BELLEVILLE TPKE
Second Line	:	SUITE 1 C
City	:	NORTH ARLINGTON
State	:	NJ
Zip	:	07031-6463
Country	:	US
Telephone Number	:	201-997-4040
Fax Number	:	201-997-4040

Provider Business Practice Location Address
First Line	:	312 BELLEVILLE TPKE
Second Line	:	SUITE 1 C
City	:	NORTH ARLINGTON
State	:	NJ
Zip	:	07031-6463
Country	:	US
Telephone Number	:	201-997-4040
Fax Number	:	201-997-4040

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

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	08/12/2014

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