Magdalena Goralczyk Endodontics PLLC

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

055832 Issued in NY

Legal business name

MAGDALENA GORALCZYK ENDODONTICS PLLC

Practice address

10308 Roosevelt Ave
Corona, NY 11368-2330

Phone

(718) 397-7000

NPI assigned

Apr 24, 2013

Last updated

Apr 24, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Miss Alicia Pitkouvich

Title

Manager

Phone

(917) 391-8000

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1366761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366761600000",
    "number": "1366886012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10308 ROOSEVELT AVE",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113682330",
            "telephone_number": "718-397-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10308 ROOSEVELT AVE",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113682330",
            "telephone_number": "718-397-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGDALENA GORALCZYK ENDODONTICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-24",
        "last_updated": "2013-04-24",
        "status": "A",
        "authorized_official_last_name": "PITKOUVICH",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "917-391-8000",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "NY",
            "license": "055832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.