Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 205558 | NY |
N | 111NI0900X | Internist | 205558 | NY |
Y | 207RX0202X | Medical Oncology | 205558 | NY |
NPI | 1053329078 |
---|---|
Provider Name | Mr. Henryk Antoni Cioczek |
First Address | Brooklyn, NY 11228-1606 |
Second Address | Brooklyn, NY 11228-1606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 12/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G45349 | (02) |