Provider Demographics
NPI:1316073364
Name:SZYMANOWSKA, ELZBIETA
Entity type:Individual
Prefix:DR
First Name:ELZBIETA
Middle Name:
Last Name:SZYMANOWSKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 LILAC LN
Mailing Address - Street 2:
Mailing Address - City:WALLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07057-2109
Mailing Address - Country:US
Mailing Address - Phone:201-933-1645
Mailing Address - Fax:201-460-7570
Practice Address - Street 1:405 HACKENSACK ST
Practice Address - Street 2:
Practice Address - City:CARLSTADT
Practice Address - State:NJ
Practice Address - Zip Code:07072-1310
Practice Address - Country:US
Practice Address - Phone:201-460-7500
Practice Address - Fax:201-460-7570
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI022246001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice