Healthcare Provider Details

I. General information

NPI: 1356365829
Provider Name (Legal Business Name): LOUIS PAWLOWSKI N.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 11/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1595 BAILEY AVE
BUFFALO NY
14212-2008
US

IV. Provider business mailing address

1595 BAILEY AVE
BUFFALO NY
14212-2008
US

V. Phone/Fax

Practice location:
  • Phone: 716-893-8550
  • Fax: 716-893-4020
Mailing address:
  • Phone: 716-893-8550
  • Fax: 716-893-4020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0000X
TaxonomyPain Management Registered Nurse
License Number303984
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0224404
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: