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Organization

MICHAEL E. KOSTELNIK, MD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL E KOSTELNIK M.D. (OWNER)
(973) 584-1405
Entity
Organization

Contact information

Practice address
52 MAIN ST, UNIT ONE, SUCCASUNNA, NJ 07876-1462
(973) 584-1405
(973) 584-6889
Mailing address
52 MAIN ST, UNIT ONE, SUCCASUNNA, NJ 07876-1462
(973) 584-1405
(973) 584-6889

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA26309
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2207401
NJ
Enumeration date
12/06/2007
Last updated
12/06/2007
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