Provider Demographics
NPI:1124097878
Name:MRUCZEK, ARTHUR W SR (MD)
Entity type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:W
Last Name:MRUCZEK
Suffix:SR
Gender:M
Credentials:MD
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Mailing Address - Street 1:500 ERIE STREET SOUTH
Mailing Address - Street 2:LPEC MEDICAL EYE CARE PLLC
Mailing Address - City:MEDINA
Mailing Address - State:NY
Mailing Address - Zip Code:14103
Mailing Address - Country:US
Mailing Address - Phone:585-798-2020
Mailing Address - Fax:585-798-3365
Practice Address - Street 1:500 ERIE STREET SOUTH
Practice Address - Street 2:LAKE PLAINS EYE CENTER
Practice Address - City:MEDINA
Practice Address - State:NY
Practice Address - Zip Code:14103
Practice Address - Country:US
Practice Address - Phone:585-798-2020
Practice Address - Fax:585-798-3365
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2008-06-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY120403207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP020120403OtherBLUE CHOICE
NY100689CROtherPREFERRED CARE
NYP017812763OtherBLUE CHOICE
NY00010122705OtherUNIVERA
NY060905000047OtherFIDELIS
NY00466862Medicaid
NY060905000047OtherFIDELIS
NYB36022Medicare UPIN
NYP017812763OtherBLUE CHOICE