Provider Demographics
NPI:1073570883
Name:BIEGUN, PIOTR (MD)
Entity Type:Individual
Prefix:
First Name:PIOTR
Middle Name:
Last Name:BIEGUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1662 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-4059
Mailing Address - Country:US
Mailing Address - Phone:518-869-9692
Mailing Address - Fax:518-869-7220
Practice Address - Street 1:1662 CENTRAL AVENUE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205
Practice Address - Country:US
Practice Address - Phone:518-869-9692
Practice Address - Fax:518-869-7220
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207478207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01775415Medicaid
NYG56145Medicare UPIN
NYN77001Medicare ID - Type Unspecified
NYN77001Medicare PIN