Shirley Ann Deknegt Kuzik
Individual provider Active NPI Social Worker · Sparta, NJ
NPI 1407089253 · NPPES record last updated Aug 10, 2020
Key facts
- NPI
- 1407089253
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 44SL05525100 (NJ)
- Practice address
- 37 Main St Ste 1091
Sparta, NJ 07871-1903 - Phone
- (973) 945-1322
- NPI assigned
- Aug 27, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44SL05525100 | NJ | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Newbridge Services, Inc. | Past | Accepting new patients | |
| Newbridge Services, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 44SL05525100 | NJ | Yes |
Addresses
Primary practice location
37 Main St Ste 1091
Sparta, NJ 07871-1903
Mailing address
364 E Shore TRL
Sparta, NJ 07871-2010
Phone (973) 945-1322
Other names
- Shirley Ann Deknegt
Other providers in Sparta, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.