Provider Demographics
NPI:1881604841
Name:DRYJSKI, MACIEJ L (MD PHD)
Entity type:Individual
Prefix:DR
First Name:MACIEJ
Middle Name:L
Last Name:DRYJSKI
Suffix:
Gender:M
Credentials:MD PHD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 8000 DEPT 313
Mailing Address - Street 2:UNIVERSITY AT BUFFALO SURGEONS INC
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14267-0002
Mailing Address - Country:US
Mailing Address - Phone:716-888-4889
Mailing Address - Fax:716-849-5620
Practice Address - Street 1:100 HIGH ST
Practice Address - Street 2:DEPT OF SURGERY
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1126
Practice Address - Country:US
Practice Address - Phone:716-859-4223
Practice Address - Fax:716-859-4222
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2014-03-26
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Provider Licenses
StateLicense IDTaxonomies
NY2000362086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01570465Medicaid
DD2309Medicare ID - Type Unspecified
G12045Medicare UPIN