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NPI Code Detail

MEDICARE: MS. MARY JEAN CIECHOSKI ANP

MEDICARE: MS. MARY JEAN CIECHOSKI ANP
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
1363LA2200XAdult Health Nurse PractitionerF303536-1NY

General Provider Information

NPI Number : 1740245992
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARY JEAN CIECHOSKI ANP
Provider Business Mailing Address
First Line : 60 MAPLE RD
Second Line : SUITE 1
City : WILLIAMSVILLE
State : NY
Zip : 14221-2917
Country : US
Telephone Number : 716-626-5250
Fax Number : 716-332-2218
Provider Business Practice Location Address
First Line : 701 SENECA ST STE 646C
Second Line :
City : BUFFALO
State : NY
Zip : 14210-1351
Country : US
Telephone Number : 716-995-4450
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2006
Last Update Date : 10/24/2019

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