Healthcare Provider Details

I. General information

NPI: 1043515703
Provider Name (Legal Business Name): DENISE STANKIEWICZ M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2011
Last Update Date: 01/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5360 GENESEE ST
BOWMANSVILLE NY
14026-1044
US

IV. Provider business mailing address

120 GARDENVALE DR
CHEEKTOWAGA NY
14225-2163
US

V. Phone/Fax

Practice location:
  • Phone: 716-783-3140
  • Fax: 716-686-8677
Mailing address:
  • Phone: 716-833-1949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number1072226
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: