Provider Demographics
NPI:1952497927
Name:HAUSNER-SYPEK, DOROTA L (MD)
Entity Type:Individual
Prefix:
First Name:DOROTA
Middle Name:L
Last Name:HAUSNER-SYPEK
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 1:4 TOWER PL
Mailing Address - Street 2:8TH FLOOR
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-3715
Mailing Address - Country:US
Mailing Address - Phone:518-489-4471
Mailing Address - Fax:518-489-4506
Practice Address - Street 1:4 TOWER PL
Practice Address - Street 2:8TH FLOOR
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-3715
Practice Address - Country:US
Practice Address - Phone:518-489-4471
Practice Address - Fax:518-489-4506
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207463174400000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01999119Medicaid
NY01999119Medicaid