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General NPI Number Information
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NPI Number | 1700073038
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Entity Type | Organization
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Legal Business Name | GENADIJ SIENKIEWICZ MD, PC
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Dates
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Enumeration Date | 10/01/2007
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Last Update Date | 10/01/2007
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Provider Practice Location Address
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Address Line | 507 MAIN ST
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City | JOHNSON CITY
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State | NY
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Zip | 13790-1810
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Country | US
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Telephone | 607-727-1019
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Fax |
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Provider Business Mailing Address
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Address Line | 3117 KNAPP RD
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City | VESTAL
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State | NY
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Zip | 13850-3038
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Country | US
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Telephone | 607-727-1019
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GENADIJ SIENKIEWICZ
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Credential | M. D.
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Telephone | 607-727-1019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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