Provider Demographics
NPI:1942240429
Name:PALECKI, WINICJUSZ (MD)
Entity Type:Individual
Prefix:DR
First Name:WINICJUSZ
Middle Name:
Last Name:PALECKI
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 1:210 JACK MARTIN BLVD
Mailing Address - Street 2:SUITE D-1
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-7771
Mailing Address - Country:US
Mailing Address - Phone:732-458-5067
Mailing Address - Fax:732-458-4962
Practice Address - Street 1:210 JACK MARTIN BLVD
Practice Address - Street 2:SUITE D-1
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-7771
Practice Address - Country:US
Practice Address - Phone:732-458-5067
Practice Address - Fax:732-458-4962
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA 72388207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
390007742OtherRAILROAD MEDICARE NUMBER
NJ8556008Medicaid
390007742OtherRAILROAD MEDICARE NUMBER
NJ8556008Medicaid