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NPI Code Detail

MEDICARE: DAVID WIECZERZYNSKI NP

MEDICARE: DAVID WIECZERZYNSKI NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerF332245NY

General Provider Information

NPI Number : 1184608648
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID WIECZERZYNSKI NP
Provider Business Mailing Address
First Line : 120 GARDENVILLE PKWY W
Second Line :
City : WEST SENECA
State : NY
Zip : 14224-1324
Country : US
Telephone Number : 716-656-4040
Fax Number : 716-656-4009
Provider Business Practice Location Address
First Line : 701 SENECA ST STE 646C
Second Line :
City : BUFFALO
State : NY
Zip : 14210-1351
Country : US
Telephone Number : 716-995-4450
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2005
Last Update Date : 10/28/2019

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