Individual
DR. WALTER SZCZUPAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1345 MOTOR PKWY FL 1, HAUPPAUGE, NY 11749-5208
(631) 855-1201
(631) 630-6299
Mailing address
PO BOX 1554, STONY BROOK, NY 11790-0988
(631) 444-0650
(631) 638-4170
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
147105
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00925993
—
NY
01
—
37D62EC831
MEDICARE OTHER PIN
NY
01
—
A300022655
MEDICARE PTAN
—
Enumeration date
09/12/2006
Last updated
09/25/2015
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