Provider Demographics
NPI:1790845386
Name:PIANKA, GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:
Last Name:PIANKA
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 1:24 SAW MILL RIVER ROAD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-1555
Mailing Address - Country:US
Mailing Address - Phone:914-631-7777
Mailing Address - Fax:914-631-0920
Practice Address - Street 1:73 E 71ST ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4213
Practice Address - Country:US
Practice Address - Phone:212-472-5899
Practice Address - Fax:212-472-1281
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY167926207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE44948Medicare UPIN
NY51F521Medicare ID - Type UnspecifiedPROVIDER NUMBER