Individual
IRENE GRGURICH CERGNUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
43 PROGRESS ST, UNION, NJ 07083-8114
(908) 258-8765
Mailing address
35 BOONTON AVE, KINNELON, NJ 07405-2941
(973) 261-6987
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
234693
NY
207QA0401X
Addiction Medicine (Family Medicine) Physician
25MA09726100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
234693
LICENSE
NY
01
—
25MA09726100
MEDICAL LICENSE
NJ
Enumeration date
10/13/2006
Last updated
04/07/2025
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