MEDICARE: ELIZABETH A KUEHNE NP

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	363LP0200X	Pediatric Nurse Practitioner	26NN07057800	NJ

General Provider Information

NPI Number	:	1669568523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH A KUEHNE NP

Provider Business Mailing Address
First Line	:	1 DIAMOND HILL RD
Second Line	:	SUMMIT MEDICAL GROUP
City	:	BERKELEY HEIGHTS
State	:	NJ
Zip	:	07922-2104
Country	:	US
Telephone Number	:	908-273-4300
Fax Number	:	908-790-6524

Provider Business Practice Location Address
First Line	:	395 PLEASANT VALLEY WAY
Second Line	:
City	:	WEST ORANGE
State	:	NJ
Zip	:	07052-2998
Country	:	US
Telephone Number	:	973-731-6100
Fax Number	:	973-731-0612

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

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	07/05/2019

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