Provider Demographics
NPI:1235275785
Name:PUCYK, DOROTA E (MD)
Entity Type:Individual
Prefix:
First Name:DOROTA
Middle Name:E
Last Name:PUCYK
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:5055 E BROADWAY BLVD
Mailing Address - Street 2:A-100
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-3640
Mailing Address - Country:US
Mailing Address - Phone:520-327-0460
Mailing Address - Fax:520-795-0225
Practice Address - Street 1:8710 N THORNYDALE RD STE 160
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85742-5037
Practice Address - Country:US
Practice Address - Phone:520-744-2900
Practice Address - Fax:520-744-3318
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2024-02-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ43712207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ141578OtherMEDICARE PTAN