MEDICARE: POLECHETTI CONSULTING LLC

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	367500000X	Certified Registered Nurse Anesthetist

General Provider Information

NPI Number	:	1316688344
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POLECHETTI CONSULTING LLC

Provider Business Mailing Address
First Line	:	555 PINE ST
Second Line	:
City	:	LOCKPORT
State	:	NY
Zip	:	14094-5547
Country	:	US
Telephone Number	:	716-465-0222
Fax Number	:

Provider Business Practice Location Address
First Line	:	1408 SWEET HOME RD STE 9
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14228-2783
Country	:	US
Telephone Number	:	716-243-8377
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOHN POLECHETTI
Credential	:	CRNA
Telephone Number	:	716-465-0222

Provider Enumeration Date	:	04/05/2022
Last Update Date	:	08/09/2023

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