Provider Demographics
NPI:1871742098
Name:SEDEK, GRZEGORZ S (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:GRZEGORZ
Middle Name:S
Last Name:SEDEK
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 LONGVIEW TRL W
Mailing Address - Street 2:
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-2022
Mailing Address - Country:US
Mailing Address - Phone:973-586-3181
Mailing Address - Fax:973-586-3181
Practice Address - Street 1:46 LONGVIEW TRL W
Practice Address - Street 2:
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-2022
Practice Address - Country:US
Practice Address - Phone:973-586-3181
Practice Address - Fax:973-586-3181
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05748200208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice