MEDICARE: DENISE SZCZUCKI, M.D., PLLC

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	2084P0800X	Psychiatry Physician	177098	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	177098	OTHER	NY	STATE LICENSE

General Provider Information

NPI Number	:	1982613410
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENISE SZCZUCKI, M.D., PLLC

Provider Business Mailing Address
First Line	:	333 MAMARONECK AVE
Second Line	:	SUITE 204
City	:	WHITE PLAINS
State	:	NY
Zip	:	10605-1440
Country	:	US
Telephone Number	:	914-588-2205
Fax Number	:

Provider Business Practice Location Address
First Line	:	333 MAMARONECK AVE
Second Line	:	SUITE 204
City	:	WHITE PLAINS
State	:	NY
Zip	:	10605-1440
Country	:	US
Telephone Number	:	914-588-2205
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. DENISE SZCZUCKI
Credential	:	M.D.
Telephone Number	:	914-588-2205

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	07/25/2007

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