Healthcare Provider Details

I. General information

NPI: 1740139708
Provider Name (Legal Business Name): CUKIERSKI MEDICAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2026
Last Update Date: 01/23/2026
Certification Date: 01/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8604 MAIN ST STE 4
WILLIAMSVILLE NY
14221-7463
US

IV. Provider business mailing address

30 MIDWAY LN
ELMA NY
14059-9136
US

V. Phone/Fax

Practice location:
  • Phone: 716-858-0243
  • Fax:
Mailing address:
  • Phone: 716-858-0243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: JACOB JOSEPH CUKIERSKI
Title or Position: OWNER/CEO
Credential: DO
Phone: 716-858-0243