Provider Demographics
NPI:1518044981
Name:GORSKI-PIASZCZYK, ANNA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:GORSKI-PIASZCZYK
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:PO BOX 2195
Mailing Address - Street 2:
Mailing Address - City:NORTH BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11703
Mailing Address - Country:US
Mailing Address - Phone:631-587-7474
Mailing Address - Fax:631-587-7450
Practice Address - Street 1:510 MONTAUK HWY
Practice Address - Street 2:SUITE D
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795
Practice Address - Country:US
Practice Address - Phone:631-587-7474
Practice Address - Fax:631-587-7450
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY184078207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01470671Medicaid
F26028Medicare UPIN
NY01470671Medicaid