Individual
MICHAEL J PIETRUSIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
3277 SOUTH PARK AVENUE, LACKAWANNA, NY 14218-3527
(716) 822-3411
(716) 822-0215
Mailing address
3277 SOUTH PARK AVENUE, LACKAWANNA, NY 14218-3527
(716) 822-3411
(716) 822-0215
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
NOO36341
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00845978
—
NY
Enumeration date
07/17/2006
Last updated
10/14/2011
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