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1497889638 NPI number — JEFFREY BRENT PAWLECKI M.D.

NPI Number: 1497889638
Health Care Provider/Practitioner: JEFFREY BRENT PAWLECKI M.D.

Information about “1497889638” NPI (JEFFREY BRENT PAWLECKI M.D.) exists in 1497889638 in HTML format HTML  |  1497889638 in plain Text format TXT  |  1497889638 in PDF (Portable Document Format) PDF  |  1497889638 in an XML format XML  formats.

NPI Number : 1497889638 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1497889638",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PAWLECKI",
    "FirstName": "JEFFREY",
    "MiddleName": "BRENT",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "PAWLECKI",
    "OtherFirstName": "J.",
    "OtherMiddleName": "BRENT",
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": null,
    "OtherCredential": "M.D.",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "200 E 32ND ST",
    "SecondLineMailingAddress": "#15A",
    "MailingAddressCityName": "NEW YORK",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "10016-6306",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "212-889-3045",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1 ELMCROFT RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "STAMFORD",
    "PracticeLocationAddressStateName": "CT",
    "PracticeLocationAddressPostalCode": "06926-0700",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "203-351-6434",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/16/2007",
    "LastUpdateDate": "07/08/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207R00000X",
          "TaxonomyName": "Internal Medicine Physician",
          "LicenseNumber": "032188",
          "LicenseNumberStateCode": "CT",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "207R00000X",
          "TaxonomyName": "Internal Medicine Physician",
          "LicenseNumber": "196778",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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