Provider Demographics
NPI:1205995248
Name:PALECKI, AGNIESZKA (MD)
Entity type:Individual
Prefix:DR
First Name:AGNIESZKA
Middle Name:
Last Name:PALECKI
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 1:848 W BAY AVE
Mailing Address - Street 2:
Mailing Address - City:BARNEGAT
Mailing Address - State:NJ
Mailing Address - Zip Code:08005-2126
Mailing Address - Country:US
Mailing Address - Phone:609-660-8100
Mailing Address - Fax:
Practice Address - Street 1:848 WEST BAY AVE
Practice Address - Street 2:UNIT E
Practice Address - City:BARNEGAT
Practice Address - State:NJ
Practice Address - Zip Code:08005
Practice Address - Country:US
Practice Address - Phone:609-660-8100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA07931500207RC0200X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine