# AW KULISCHENKO MD, I KULISCHENKO, MD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023062163
- **Authorized official:** DR. ALEXANDER W KULISCHENKO MD (PROP./OWNER)
- **Authorized official phone:** (732) 613-9155

## Contact information

- **Practice address:** 495 RYDERS LN, EAST BRUNSWICK, NJ 08816-2769
- **Practice address phone:** (732) 613-9155
- **Practice address fax:** (732) 651-0804
- **Mailing address:** 495 RYDERS LN, EAST BRUNSWICK, NJ 08816-2769
- **Mailing address phone:** (732) 613-9155
- **Mailing address fax:** (732) 651-0804

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | MA43009 | NJ | Yes |

## Other

- **Enumeration date:** 05/22/2006
- **Last updated:** 10/16/2007