Brian Edward Kiczek, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

38MC00587000 Issued in NJ

Practice address

216 Anderson Ave
Rear Office
Fairview, NJ 07022-1468

Phone

(201) 313-8880

Fax

(201) 313-8880

NPI assigned

Apr 24, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dr. Brian E. Kiczek

  • Chiropractor
  • Fairview, NJ
  • NPI 1265621841
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217203200000",
    "number": "1295954030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 ANDERSON AV.",
            "address_2": "REAR OFFICE",
            "city": "FAIRVIEW",
            "state": "NJ",
            "postal_code": "07022",
            "telephone_number": "201-313-8880",
            "fax_number": "201-313-8880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 ANDERSON AVE",
            "address_2": "REAR OFFICE",
            "city": "FAIRVIEW",
            "state": "NJ",
            "postal_code": "070221468",
            "telephone_number": "201-313-8880",
            "fax_number": "201-313-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KICZEK",
        "first_name": "BRIAN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2008-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00587000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Fairview, NJ
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.