Basic Information
| Provider Information | |||||||||
| NPI: | 1962950212 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KUSNIRIK | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | IV | ||||||||
| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3 CENTURY DR | ||||||||
| Address2: | |||||||||
| City: | PARSIPPANY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070544610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9737400609 | ||||||||
| FaxNumber: | 9734365660 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 CAPITAL WAY | ||||||||
| Address2: | |||||||||
| City: | PENNINGTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 085342520 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6093034000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2016 | ||||||||
| LastUpdateDate: | 09/15/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | NJ | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.