Provider Demographics
NPI:1104962372
Name:STRZELECKI, TADEUSZ (MD)
Entity type:Individual
Prefix:DR
First Name:TADEUSZ
Middle Name:
Last Name:STRZELECKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 GREENWAY E
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-2245
Mailing Address - Country:US
Mailing Address - Phone:516-746-0399
Mailing Address - Fax:
Practice Address - Street 1:29 JERICHO TPKE STE A
Practice Address - Street 2:
Practice Address - City:JERICHO
Practice Address - State:NY
Practice Address - Zip Code:11753-1053
Practice Address - Country:US
Practice Address - Phone:516-280-9822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2013-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA07881700207ZP0102X
NY188331207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH11608Medicare UPIN
NYBB9331Medicare PIN