Provider Demographics
NPI:1750592572
Name:GEORGE J. CIECHANOWSKI, M.D.,P.C.
Entity type:Organization
Organization Name:GEORGE J. CIECHANOWSKI, M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:CIECHANOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-963-7000
Mailing Address - Street 1:408 SUMMIT AVE
Mailing Address - Street 2:1ST FLR
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-3101
Mailing Address - Country:US
Mailing Address - Phone:201-963-7000
Mailing Address - Fax:201-963-8331
Practice Address - Street 1:408 SUMMIT AVE
Practice Address - Street 2:1ST FLR
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-3101
Practice Address - Country:US
Practice Address - Phone:201-963-7000
Practice Address - Fax:201-963-8331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0751006Medicaid
NJC58801Medicare UPIN
NJ0751006Medicaid