Provider Demographics
NPI:1912085127
Name:PIENKNY, ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:PIENKNY
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 1:2999 REGENT ST STE 612
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-2121
Mailing Address - Country:US
Mailing Address - Phone:510-848-1727
Mailing Address - Fax:510-848-8224
Practice Address - Street 1:2999 REGENT ST STE 612
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-2121
Practice Address - Country:US
Practice Address - Phone:510-848-1727
Practice Address - Fax:510-848-8224
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA71078208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH26675Medicare UPIN
CAYYY49005YMedicare ID - Type Unspecified