MEDICARE: MICHAEL FRANCIS OWCZARCZAK

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	101YM0800X	Mental Health Counselor	008492	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	008492	OTHER	NY	OFFICE OF PROFESSIONS

General Provider Information

NPI Number	:	1700426285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL FRANCIS OWCZARCZAK

Provider Business Mailing Address
First Line	:	105 CROSSPOINT PKWY
Second Line	:
City	:	AMHERST
State	:	NY
Zip	:	14068-1603
Country	:	US
Telephone Number	:	716-564-3630
Fax Number	:

Provider Business Practice Location Address
First Line	:	105 CROSSPOINT PKWY
Second Line	:
City	:	AMHERST
State	:	NY
Zip	:	14068-1603
Country	:	US
Telephone Number	:	716-564-3630
Fax Number	:

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

Provider Enumeration Date	:	01/13/2020
Last Update Date	:	01/13/2020

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