Healthcare Provider Details

I. General information

NPI: 1619934031
Provider Name (Legal Business Name): PIOTR S SOBIESZCZYK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 09/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 FRANCIS STREET BRIGHAM AND WOMENS HOSPITAL CARDIOVASCULAR DIVISION
BOSTON MA
02115
US

IV. Provider business mailing address

375 BOYLSTON ST
BROOKLINE MA
02445-6007
US

V. Phone/Fax

Practice location:
  • Phone: 857-307-1991
  • Fax: 857-307-1955
Mailing address:
  • Phone: 857-307-0896
  • Fax: 857-307-0899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number161073
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: