Healthcare Provider Details

I. General information

NPI: 1710714159
Provider Name (Legal Business Name): NATALIA MARIA SZCZECH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2024
Last Update Date: 09/18/2024
Certification Date: 08/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 WATERS PL
BRONX NY
10461-2720
US

IV. Provider business mailing address

2021 GROVE ST # 1
RIDGEWOOD NY
11385-2443
US

V. Phone/Fax

Practice location:
  • Phone: 718-920-2060
  • Fax:
Mailing address:
  • Phone: 646-469-8034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: