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NPI Code Detail

MEDICARE: RENEE STOTZ LPN

MEDICARE:   RENEE  STOTZ  LPN
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
1164W00000XLicensed Practical Nurse10-311107NY

General Provider Information

NPI Number : 1649677105
Entity Type Code : Individual
Provider Name (Legal Business Name) : RENEE STOTZ LPN
Provider Business Mailing Address
First Line : 2081 PERRY RD
Second Line :
City : NORTH JAVA
State : NY
Zip : 14113-9723
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2081 PERRY RD
Second Line :
City : NORTH JAVA
State : NY
Zip : 14113-9723
Country : US
Telephone Number : 585-322-3243
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2014
Last Update Date : 05/06/2015

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Directions to “ RENEE STOTZ LPN” Practice Location

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