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NPI Code Detail

MEDICARE: JENNIFER BAKOWSKI

MEDICARE: JENNIFER BAKOWSKI
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 Practitioner358810NY

General Provider Information

NPI Number : 1518815919
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER BAKOWSKI
Provider Business Mailing Address
First Line : 133 MARJORIE DR
Second Line :
City : BUFFALO
State : NY
Zip : 14223-2421
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 133 MARJORIE DR
Second Line :
City : BUFFALO
State : NY
Zip : 14223-2421
Country : US
Telephone Number : 716-200-2511
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2026
Last Update Date : 03/20/2026

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