Individual provider Active NPI

Rosemary Wieczorek, M.D.

  • Immunopathology Physician
  • Brooklyn, NY
National Provider Identifier
1962513275
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Immunopathology PhysicianTaxonomy code 207ZI0100X
License
155089-1 Issued in NY
Practice address
800 Poly PL
Lab Service
Brooklyn, NY 11209-7104
Phone
(718) 836-6600
Fax
(212) 951-6341
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Immunopathology Physician 207ZI0100X 155089-1 NY Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 155089-1 NY

Addresses

Primary practice location

800 Poly PL
Lab Service
Brooklyn, NY 11209-7104

Mailing address

800 Poly PL
Lab Service
Brooklyn, NY 11209-7104
Phone (718) 836-6600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
155089-1NYMDImmunopathology Physician

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1962513275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 POLY PL",
            "address_2": "LAB SERVICE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112097104",
            "telephone_number": "718-836-6600",
            "fax_number": "212-951-6341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 POLY PL",
            "address_2": "LAB SERVICE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112097104",
            "telephone_number": "718-836-6600",
            "fax_number": "212-951-6341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIECZOREK",
        "first_name": "ROSEMARY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZI0100X",
            "taxonomy_group": "",
            "desc": "Pathology, Immunopathology",
            "state": "NY",
            "license": "155089-1",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "155089-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.