Provider Demographics
NPI:1306814132
Name:DUCHNOWSKA, ALICJA B (MD)
Entity Type:Individual
Prefix:
First Name:ALICJA
Middle Name:B
Last Name:DUCHNOWSKA
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 1:934 IONIA AVENUE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309-2308
Mailing Address - Country:US
Mailing Address - Phone:718-984-5255
Mailing Address - Fax:718-984-4132
Practice Address - Street 1:934 IONIA AVENUE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-2308
Practice Address - Country:US
Practice Address - Phone:718-984-5255
Practice Address - Fax:718-984-4132
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY151044208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics