MEDICARE: SARA E STACHOWIAK LMT

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	174400000X	Specialist	024213	NY

General Provider Information

NPI Number	:	1376842310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA E STACHOWIAK LMT

Provider Business Mailing Address
First Line	:	3868 E ROBINSON RD
Second Line	:
City	:	AMHERST
State	:	NY
Zip	:	14228-2001
Country	:	US
Telephone Number	:	716-912-1281
Fax Number	:	866-907-6157

Provider Business Practice Location Address
First Line	:	3868 E ROBINSON RD
Second Line	:
City	:	AMHERST
State	:	NY
Zip	:	14228-2001
Country	:	US
Telephone Number	:	716-912-1281
Fax Number	:	866-907-6157

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

Provider Enumeration Date	:	03/16/2011
Last Update Date	:	03/16/2011

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