MEDICARE: MICHAEL J PACIOREK MD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	198702	NY

General Provider Information

NPI Number	:	1952497026
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL J PACIOREK MD PC

Provider Business Mailing Address
First Line	:	PO BOX 4738
Second Line	:
City	:	SYRACUSE
State	:	NY
Zip	:	13221-4738
Country	:	US
Telephone Number	:	315-464-2237
Fax Number	:	315-464-3235

Provider Business Practice Location Address
First Line	:	BROAD RD SOUTH 2D
Second Line	:	COMMUNITY GENERAL HOSPITAL POB
City	:	SYRACUSE
State	:	NY
Zip	:	13215
Country	:	US
Telephone Number	:	315-492-5755
Fax Number	:	315-492-5246

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MICHAEL J PACIOREK
Credential	:	MD
Telephone Number	:	315-492-5755

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	07/16/2013

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