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General NPI Number Information
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NPI Number | 1003136227
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Entity Type | Individual
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Provider Name | DARIA K JANECEK L.M.T.
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Gender | Female
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Dates
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Enumeration Date | 06/10/2010
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Last Update Date | 06/10/2010
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Provider Practice Location Address
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Address Line | 8458 PERSIAN TER
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City | CICERO
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State | NY
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Zip | 13039-8852
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Country | US
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Telephone | 315-395-4685
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Fax | 315-699-7022
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Provider Business Mailing Address
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Address Line | 8458 PERSIAN TER
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City | CICERO
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State | NY
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Zip | 13039-8852
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Country | US
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Telephone | 315-395-4685
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Fax | 315-699-7022
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 012119-1
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License Number State | NY
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