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General NPI Number Information
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NPI Number | 1871555797
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Entity Type | Individual
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Provider Name | ELZBIETA J WIRKOWSKI MD
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Gender | Female
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Dates
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Enumeration Date | 04/05/2006
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Last Update Date | 12/31/2024
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Provider Practice Location Address
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Address Line | NEW YORK SPINE & BRAIN SURGERY HSC T12 RM 080
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City | STONY BROOK
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State | NY
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Zip | 11794-4235
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Country | US
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Telephone | 631-444-1116
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Fax | 631-444-1535
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Provider Business Mailing Address
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Address Line | NEW YORK SPINE & BRAIN SURGERY HSC T12 RM 080
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City | STONY BROOK
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State | NY
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Zip | 11794-8122
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Country | US
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Telephone | 631-444-1116
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Fax | 631-444-1535
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084V0102X
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Taxonomy Name | Vascular Neurology Physician
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License Number | 180512
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084A2900X
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Taxonomy Name | Neurocritical Care Physician
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License Number | 180512
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License Number State | NY
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