Provider Demographics
NPI:1043485691
Name:GEDZIOR, JOANNA SABINA (MD)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:SABINA
Last Name:GEDZIOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270-05 76TH AVENUE CONSULTATION PSYCHIATRY
Mailing Address - Street 2:THE NORTH SHORE - LONG ISLAND JEWISH HEALTH SYSTEM
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040
Mailing Address - Country:US
Mailing Address - Phone:718-470-4650
Mailing Address - Fax:
Practice Address - Street 1:270-05 76TH AVENUE CONSULTATION PSYCHIATRY
Practice Address - Street 2:THE NORTH SHORE - LONG ISLAND JEWISH HEALTH SYSTEM
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040
Practice Address - Country:US
Practice Address - Phone:718-470-4650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-24
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY248325-12084P0800X
NY2483252084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry