Provider Demographics
NPI:1528007457
Name:KWAPNIEWSKI, AGNIESZKA M (MD)
Entity type:Individual
Prefix:MRS
First Name:AGNIESZKA
Middle Name:M
Last Name:KWAPNIEWSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:312 BELLEVILLE TPKE
Mailing Address - Street 2:SUITE 1 C
Mailing Address - City:NORTH ARLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07031-6463
Mailing Address - Country:US
Mailing Address - Phone:201-997-4040
Mailing Address - Fax:201-997-4040
Practice Address - Street 1:312 BELLEVILLE TPKE
Practice Address - Street 2:SUITE 1 C
Practice Address - City:NORTH ARLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07031-6463
Practice Address - Country:US
Practice Address - Phone:201-997-4040
Practice Address - Fax:201-997-4040
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA07529400207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJI11636Medicare UPIN
NJ081314RPEMedicare ID - Type Unspecified