Provider Demographics
NPI:1013932334
Name:CHRZANOWSKI, PAUL JONATHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:JONATHAN
Last Name:CHRZANOWSKI
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 1:200 W 86TH ST
Mailing Address - Street 2:SUITE 1I
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3303
Mailing Address - Country:US
Mailing Address - Phone:212-873-1840
Mailing Address - Fax:212-724-6158
Practice Address - Street 1:200 W 86TH ST
Practice Address - Street 2:SUITE 1I
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3303
Practice Address - Country:US
Practice Address - Phone:212-873-1840
Practice Address - Fax:212-724-6158
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY110320207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB12499Medicare UPIN
NY299001Medicare ID - Type Unspecified