=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871558478
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DENISE MARIE PIECHOWSKI PNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/18/2006
-----------------------------------------------------
Last Update Date | 08/09/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1095 JEFFERSON AVE MAKOWSKI SCHOOL-BASED HEALTH CENTER
-----------------------------------------------------
City | BUFFALO
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14208-2414
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-883-9482
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 608 WOODBURY DR
-----------------------------------------------------
City | NORTH TONAWANDA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14120-1836
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-693-2104
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0200X
-----------------------------------------------------
Taxonomy Name | Pediatric Nurse Practitioner
-----------------------------------------------------
License Number | F381604
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------