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Individual
KATHYLYNN C PIETAK
Active
Individual
KATHYLYNN C PIETAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
200533
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010491902
UNIVERA
NY
01
—
000525623002
BC/BS
NY
05
—
01970263
—
NY
01
—
040426002676
FIDELIS
NY
01
—
0410911
IHA
NY
01
—
145444BJ
PREFERRED CARE
NY
Enumeration date
02/20/2006
Last updated
07/21/2014
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