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Individual

DR. WANDA JANINA MIKULSKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1310 BROAD ST, BLOOMFIELD, NJ 07003
(973) 338-5660
(973) 338-0522
Mailing address
1310 BROAD ST, BLOOMFIELD, NJ 07003
(973) 338-5660
(973) 338-0522

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MA035627
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1097806
NJ
Enumeration date
08/29/2006
Last updated
04/17/2009
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