Provider Demographics
NPI:1669611356
Name:ALEXANDER M. PIEKARSKI, PH.D.,PSYCHOLOGIST, P.C.
Entity type:Organization
Organization Name:ALEXANDER M. PIEKARSKI, PH.D.,PSYCHOLOGIST, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DR.
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:M
Authorized Official - Last Name:PIEKARSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:631-878-1530
Mailing Address - Street 1:PO BOX 101
Mailing Address - Street 2:
Mailing Address - City:EAST MORICHES
Mailing Address - State:NY
Mailing Address - Zip Code:11940-0101
Mailing Address - Country:US
Mailing Address - Phone:631-878-1530
Mailing Address - Fax:631-878-5775
Practice Address - Street 1:587 MONTAUK HWY
Practice Address - Street 2:
Practice Address - City:EAST MORICHES
Practice Address - State:NY
Practice Address - Zip Code:11940-1234
Practice Address - Country:US
Practice Address - Phone:631-878-1530
Practice Address - Fax:631-878-5775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-19
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV4C551OtherMEDICARE P TAN #
NYV4C551OtherMEDICARE P TAN #