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NPI Code Detail

MEDICARE: MRS. PEGGY S URBANCZYK RN

MEDICARE: MRS. PEGGY S URBANCZYK RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse PractitionerF30962501NY

General Provider Information

NPI Number : 1619151560
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. PEGGY S URBANCZYK RN
Provider Business Mailing Address
First Line : 860 MAIN RD STE 2
Second Line :
City : CORFU
State : NY
Zip : 14036-9753
Country : US
Telephone Number : 585-599-6446
Fax Number : 585-344-3047
Provider Business Practice Location Address
First Line : 860 MAIN RD STE 2
Second Line :
City : CORFU
State : NY
Zip : 14036-9753
Country : US
Telephone Number : 585-599-6446
Fax Number : 585-344-3047
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/27/2007
Last Update Date : 07/30/2020

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