MEDICARE: ALEXIS PINIEWSKI

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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1235815481
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXIS PINIEWSKI

Provider Business Mailing Address
First Line	:	111 MACKENAN DR
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27511-7903
Country	:	US
Telephone Number	:	919-371-2848
Fax Number	:

Provider Business Practice Location Address
First Line	:	3820 RANDOLPH HEIGHTS DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28205-7566
Country	:	US
Telephone Number	:	716-997-4495
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2023
Last Update Date	:	06/23/2023

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Directions to “ ALEXIS PINIEWSKI ” Practice Location

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