Provider Demographics
NPI:1851699664
Name:PIECZENIK MARANGO, STEPHANIE (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:
Last Name:PIECZENIK MARANGO
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 1:800A 5TH AVE
Mailing Address - Street 2:#205
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-7215
Mailing Address - Country:US
Mailing Address - Phone:212-758-3200
Mailing Address - Fax:
Practice Address - Street 1:800A 5TH AVE
Practice Address - Street 2:#205
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7215
Practice Address - Country:US
Practice Address - Phone:212-758-3200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-02
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY260166208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice