Healthcare Provider Details
I. General information
NPI: 1366456238
Provider Name (Legal Business Name): PIOTR GORECKI M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/28/2006
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
506 6TH ST
BROOKLYN NY
11215-3609
US
IV. Provider business mailing address
506 6TH ST
BROOKLYN NY
11215-3609
US
V. Phone/Fax
- Phone: 718-780-3288
- Fax: 718-780-3154
- Phone: 718-780-3288
- Fax: 718-780-3154
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 208502 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: