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Contact Information

THEODORE BLASZCZYK, MD
200 E MAIN ST STE 1E
SMITHTOWN, NY11787
 Phone: 631-265-4567
 Fax: 631-265-4704
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Obstetrics & Gynecology

207V00000X 16 Physician/Obstetrics & Gynecology
 

Gynecology

207VG0400X 16 Physician/Obstetrics & Gynecology
 

Obstetrics

207VX0000X 16 Physician/Obstetrics & Gynecology
Indicates primary specialty

NPI Profile & details for THEODORE BLASZCZYK · (Male)

NPI # 1962588640
Status Active
Credentials MD
Entity Individual
Enumeration date 10/27/2006
Last updated 04/27/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 169211
Hospital affiliation(s)
  • JOHN T MATHER MEMORIAL HOSPITAL OF PORT JEFFERSON - (Acute Care)
    75 NORTH COUNTRY ROAD
    PORT JEFFERSON, NY 11777
  • UNIVERSITY HOSPITAL ( STONY BROOK ) - (Acute Care)
    HEALTH SCIENCES CENTER SUNY
    STONY BROOK, NY 11794
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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