Provider Demographics
NPI:1861573206
Name:WOJCIECH PALKA MD PC
Entity type:Organization
Organization Name:WOJCIECH PALKA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WOJCIECH
Authorized Official - Middle Name:
Authorized Official - Last Name:PALKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-787-9318
Mailing Address - Street 1:PO BOX 237077
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023
Mailing Address - Country:US
Mailing Address - Phone:212-787-9318
Mailing Address - Fax:212-787-9318
Practice Address - Street 1:LENOX HILL HOSPITAL 100 EAST 77TH STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021
Practice Address - Country:US
Practice Address - Phone:212-787-9318
Practice Address - Fax:212-787-9318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY215044207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP1923283OtherOXFORD
NY02074528Medicaid
NY7V3481OtherBLUE CROSS
NY7V3481OtherBLUE CROSS
NY02074528Medicaid