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NPI Code Detail

MEDICARE: SUSAN KADLEC

MEDICARE: SUSAN KADLEC
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
1367A00000XAdvanced Practice Midwife25ME00031900NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
125ME00031900OTHERNJCNM LIC
225ME00031901OTHERNJCNM W/PRESCRIPTIVE AUTH

General Provider Information

NPI Number : 1861403578
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN KADLEC
Provider Business Mailing Address
First Line : 1700 MYRTLE AVE
Second Line :
City : PLAINFIELD
State : NJ
Zip : 07063-1000
Country : US
Telephone Number : 908-753-6401
Fax Number :
Provider Business Practice Location Address
First Line : 1700 MYRTLE AVE
Second Line :
City : PLAINFIELD
State : NJ
Zip : 07063-1000
Country : US
Telephone Number : 908-753-6401
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2006
Last Update Date : 03/07/2013

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Directions to “ SUSAN KADLEC ” Practice Location

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