Provider Demographics
NPI:1720061070
Name:MAJCHRZAK, TADEUSZ JANUSZ (MD)
Entity type:Individual
Prefix:
First Name:TADEUSZ
Middle Name:JANUSZ
Last Name:MAJCHRZAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8329
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07308-8329
Mailing Address - Country:US
Mailing Address - Phone:201-963-0800
Mailing Address - Fax:201-656-6934
Practice Address - Street 1:3000 KENNEDY BLVD STE 308
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-3817
Practice Address - Country:US
Practice Address - Phone:201-963-0800
Practice Address - Fax:201-656-6934
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-21
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA5867500207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
223779589OtherTAX ID
433198Medicare ID - Type Unspecified
223779589OtherTAX ID