Healthcare Provider Details

I. General information

NPI: 1548446123
Provider Name (Legal Business Name): PETER J RIZNYK DPM PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2008
Last Update Date: 06/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6272 W QUAKER ST
ORCHARD PARK NY
14127-2644
US

IV. Provider business mailing address

6272 W QUAKER ST
ORCHARD PARK NY
14127-2644
US

V. Phone/Fax

Practice location:
  • Phone: 716-662-7729
  • Fax: 716-662-1822
Mailing address:
  • Phone: 716-662-7729
  • Fax: 716-662-1822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number004194
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number004194
License Number StateNY

VIII. Authorized Official

Name: PETER J RIZNYK
Title or Position: DPM
Credential:
Phone: 716-662-7729