Provider Demographics
NPI:1992049167
Name:JOSEPH W SZCZESNIAK MD PC
Entity type:Organization
Organization Name:JOSEPH W SZCZESNIAK MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:W
Authorized Official - Last Name:SZCZESNIAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-365-5206
Mailing Address - Street 1:1077 NORTHERN BLVD
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-1614
Mailing Address - Country:US
Mailing Address - Phone:516-365-5206
Mailing Address - Fax:516-365-0602
Practice Address - Street 1:1077 NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576-1614
Practice Address - Country:US
Practice Address - Phone:516-365-5206
Practice Address - Fax:516-365-0602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-12
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY169927261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYD92128Medicare UPIN