Individual ProviderMaciej DomekInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address1470 Madison Ave, Mount Sinai Hospital - General Internal Medicine, New York, NY 10029(212) 659-8551(212) 987-3100PECOS EnrollmentBased on the most recent information from CMS, provider Maciej Domek is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 6 days ago.Profile DetailsProvider ID1598796013Provider TypeIndividualFull NameDomek, MaciejCredentialMDGenderMaleSole ProprietorNoEnumeration Date7/5/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address1470 Madison Ave, Mount Sinai Hospital - General Internal Medicine, New York, NY 10029Phone(212) 659-8551Fax(212) 831-8116Mailing LocationMailing Address1 Gustave L Levy Place - Box 300, Mount Sinai Department Of Medicine, New York, NY 10029Phone(212) 987-3100Fax(212) 731-5210Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense233424New York