Individual
KATHLEEN M. CERKVENIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
541 CEDAR HILL AVE, WYCKOFF, NJ 07481-2150
(201) 652-0300
(201) 444-6209
Mailing address
541 CEDAR HILL AVENUE, WYCKOFF, NJ 07481-2150
(201) 445-4630
(201) 444-6209
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MA042021
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
222110646
BUSINESS TAX ID #
NJ
Enumeration date
03/20/2006
Last updated
04/05/2012
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