Organization
MICHAEL J PIETRUSIK DPM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL PIETRUSIK (DPM)
(716) 822-3411
Entity
Organization
Contact information
Practice address
3277 S PARK AVE, LACKAWANNA, NY 14218-3527
(716) 822-3411
Mailing address
3277 S PARK AVE, LACKAWANNA, NY 14218-3527
(716) 822-3411
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
N0036341
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00845978
—
NY
Enumeration date
01/15/2008
Last updated
01/15/2008
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