Provider Demographics
NPI:1982613410
Name:DENISE SZCZUCKI, M.D., PLLC
Entity Type:Organization
Organization Name:DENISE SZCZUCKI, M.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:SZCZUCKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-588-2205
Mailing Address - Street 1:333 MAMARONECK AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-1440
Mailing Address - Country:US
Mailing Address - Phone:914-588-2205
Mailing Address - Fax:
Practice Address - Street 1:333 MAMARONECK AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-1440
Practice Address - Country:US
Practice Address - Phone:914-588-2205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1770982084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY177098OtherSTATE LICENSE
NY06H992Medicare UPIN