Individual
MICHAEL THEODORE KICENUIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
254 EASTON AVENUE, WOMEN'S HEALTH -CARES BUILDING 3 RD FLOOR, NEW BRUNSWICK, NJ 08901
(732) 937-6003
(732) 249-6140
Mailing address
51 GEIGER LANE, WARREN, NJ 07059-5641
(732) 718-7108
(732) 563-9181
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
25MA03343200
NJ
Other
Enumeration date
07/08/2005
Last updated
09/10/2008
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