Provider Demographics
NPI:1952497026
Name:MICHAEL J PACIOREK MD PC
Entity Type:Organization
Organization Name:MICHAEL J PACIOREK MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:PACIOREK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-492-5755
Mailing Address - Street 1:PO BOX 4738
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13221-4738
Mailing Address - Country:US
Mailing Address - Phone:315-464-2237
Mailing Address - Fax:315-464-3235
Practice Address - Street 1:BROAD RD SOUTH 2D
Practice Address - Street 2:COMMUNITY GENERAL HOSPITAL POB
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13215
Practice Address - Country:US
Practice Address - Phone:315-492-5755
Practice Address - Fax:315-492-5246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY198702207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBA0428Medicare PIN