Provider Demographics
NPI:1437120466
Name:PRZECHODZKI, TADEUSZ W (MD)
Entity Type:Individual
Prefix:DR
First Name:TADEUSZ
Middle Name:W
Last Name:PRZECHODZKI
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 1:65 HAMPDEN LN
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:10533-2424
Mailing Address - Country:US
Mailing Address - Phone:914-591-3271
Mailing Address - Fax:914-470-2766
Practice Address - Street 1:127 S BROADWAY
Practice Address - Street 2:SUITE: REHAB DEPARTMENT
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-4006
Practice Address - Country:US
Practice Address - Phone:914-591-3271
Practice Address - Fax:914-470-2766
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-28
Last Update Date:2012-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY150211207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00766601Medicaid
NYB18743Medicare UPIN
NY70A011Medicare ID - Type UnspecifiedMEDICARE