MEDICARE: JEANNE KORNOWICZ

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	171W00000X	Contractor

General Provider Information

NPI Number	:	1316288400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANNE KORNOWICZ

Provider Business Mailing Address
First Line	:	224 WELLINGTON RD
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14216-2427
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4242 RIDGE LEA RD
Second Line	:	SUITE 2
City	:	AMHERST
State	:	NY
Zip	:	14226-1051
Country	:	US
Telephone Number	:	716-819-2400
Fax Number	:

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

Provider Enumeration Date	:	03/14/2013
Last Update Date	:	03/14/2013

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Directions to “ JEANNE KORNOWICZ ” Practice Location

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