Healthcare Provider Details

I. General information

NPI: 1891991287
Provider Name (Legal Business Name): WOJCIECH DEC M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2007
Last Update Date: 10/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 1ST AVE
NEW YORK NY
10016-6402
US

IV. Provider business mailing address

343 E 30TH ST APT. 12F
NEW YORK NY
10016-6417
US

V. Phone/Fax

Practice location:
  • Phone: 212-686-7500
  • Fax:
Mailing address:
  • Phone: 917-592-3147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2082S0099X
TaxonomyPlastic Surgery Within the Head and Neck (Plastic Surgery) Physician
License NumberP5793
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: