Healthcare Provider Details

I. General information

NPI: 1861476715
Provider Name (Legal Business Name): WOJCIECH SKRZYPIEC MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2005
Last Update Date: 10/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 DONGAN HILLS AVE SUITE 2E
STATEN ISLAND NY
10305-1246
US

IV. Provider business mailing address

235 DONGAN HILLS AVE SUITE 2E
STATEN ISLAND NY
10305-1246
US

V. Phone/Fax

Practice location:
  • Phone: 718-667-7756
  • Fax: 718-667-7757
Mailing address:
  • Phone: 718-667-7756
  • Fax: 718-667-7757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number191990
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number191990
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number191990
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: