MEDICARE: MICHAL J TRACZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	252359-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528032521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAL J TRACZ M.D.

Provider Business Mailing Address
First Line	:	2 CROSFIELD AVE
Second Line	:	SUITE 312
City	:	WEST NYACK
State	:	NY
Zip	:	10994-2226
Country	:	US
Telephone Number	:	845-358-2400
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 CROSFIELD AVE
Second Line	:	SUITE 312
City	:	WEST NYACK
State	:	NY
Zip	:	10994-2220
Country	:	US
Telephone Number	:	845-358-2400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	07/04/2013

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