Individual provider Active NPI

George Kihiczak, M.D.

  • Procedural Dermatology Physician
  • Millburn, NJ
National Provider Identifier
1376696997
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Procedural Dermatology PhysicianTaxonomy code 207NS0135X
License
25MA02533700 Issued in NJ
Practice address
116 Millburn Ave
Suite 111
Millburn, NJ 07041-1943
Phone
(973) 467-5499
NPI assigned
Jan 18, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 25MA02533700 NJ
Procedural Dermatology Physician 207NS0135X 25MA02533700 NJ Primary

Addresses

Primary practice location

116 Millburn Ave
Suite 111
Millburn, NJ 07041-1943

Mailing address

116 Millburn Ave
Suite 111
Millburn, NJ 07041-1943
Phone (973) 467-5499

Other identifiers 1

IdentifierTypeStateIssuer
1554701MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050315000350 NJ Practitioner - Dermatology 9234184045 Practice locations: Millburn, NJ

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA02533700NJMDDermatology Physician

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1376696997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 MILLBURN AVE",
            "address_2": "SUITE 111",
            "city": "MILLBURN",
            "state": "NJ",
            "postal_code": "070411943",
            "telephone_number": "973-467-5499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 MILLBURN AVE",
            "address_2": "SUITE 111",
            "city": "MILLBURN",
            "state": "NJ",
            "postal_code": "070411943",
            "telephone_number": "973-467-5499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIHICZAK",
        "first_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "25MA02533700",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "NJ",
            "license": "25MA02533700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1554701",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Millburn, NJ

Sources for this page

Verify at the official NPI Registry.