Provider Demographics
NPI:1417999236
Name:STOROZYNSKY, EUGENE (MD)
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:
Last Name:STOROZYNSKY
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 1:925 CHESTNUT STREET
Mailing Address - Street 2:MEZZANINE
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107
Mailing Address - Country:US
Mailing Address - Phone:215-955-2050
Mailing Address - Fax:215-503-0052
Practice Address - Street 1:925 CHESTNUT STREET
Practice Address - Street 2:MEZZANINE
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4216
Practice Address - Country:US
Practice Address - Phone:215-955-2050
Practice Address - Fax:215-503-0052
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD474699207RA0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000929768001OtherBC/BS OF WESTERN NY
NY02752472Medicaid
NYP020225832OtherBLUE SHIELD
NY000929768001OtherBC/BS OF WESTERN NY