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General NPI Number Information
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NPI Number | 1891784864
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Entity Type | Individual
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Provider Name | PAUL GORCZYCA D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 10/20/2005
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Last Update Date | 11/05/2009
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Provider Practice Location Address
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Address Line | 18 E 50TH ST 8TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10022-6817
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Country | US
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Telephone | 212-759-3883
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Fax |
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Provider Business Mailing Address
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Address Line | 326 W 17TH ST #4W
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City | NEW YORK
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State | NY
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Zip | 10011-5010
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Country | US
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Telephone | 212-989-0458
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 048834
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License Number State | NY
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