Healthcare Provider Details

I. General information

NPI: 1164071155
Provider Name (Legal Business Name): OLIVIA MARIE PIEGAY PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: OLIVIA MARIE SCHLAGER PHD

II. Dates (important events)

Enumeration Date: 09/11/2019
Last Update Date: 09/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E AND WEST RD
WEST SENECA NY
14224-3604
US

IV. Provider business mailing address

7695 JEWETT HOLMWOOD RD
ORCHARD PARK NY
14127-3009
US

V. Phone/Fax

Practice location:
  • Phone: 716-532-1049
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number023379
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: