Provider Demographics
NPI:1730180555
Name:KURNIK, BRENDA R (MD)
Entity type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:R
Last Name:KURNIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 PALMER DR
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-3882
Mailing Address - Country:US
Mailing Address - Phone:856-905-8943
Mailing Address - Fax:856-988-8069
Practice Address - Street 1:1100 SHEPPARD ROAD
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043
Practice Address - Country:US
Practice Address - Phone:856-424-7390
Practice Address - Fax:844-295-1371
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2023-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04657800207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8945004Medicaid
NJP00184991OtherRAILROAD MEDICARE
NJ8945004Medicaid
PA049453Medicare PIN
NJ587811Medicare PIN