Provider Demographics
NPI:1174898928
Name:KRZYSZTOF SYGNAROWICZ PHYSICIAN PC
Entity type:Organization
Organization Name:KRZYSZTOF SYGNAROWICZ PHYSICIAN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:KRZYSZTOF
Authorized Official - Middle Name:
Authorized Official - Last Name:SYGNAROWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-789-4187
Mailing Address - Street 1:5 CEDAR COURT
Mailing Address - Street 2:
Mailing Address - City:COPIAGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11726
Mailing Address - Country:US
Mailing Address - Phone:631-789-4187
Mailing Address - Fax:631-789-4747
Practice Address - Street 1:5 CEDAR CT
Practice Address - Street 2:
Practice Address - City:COPIAGUE
Practice Address - State:NY
Practice Address - Zip Code:11726-4733
Practice Address - Country:US
Practice Address - Phone:631-789-4187
Practice Address - Fax:631-789-4747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-13
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY189552207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1982775326OtherNPI-FOR INDIVIDUAL
NY01390330Medicaid
NY1174898928Medicare NSC
NY1982775326OtherNPI-FOR INDIVIDUAL