Provider Demographics
NPI:1104823426
Name:PIEKLO, THOMAS M (DPM)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:M
Last Name:PIEKLO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:HORNELL
Mailing Address - State:NY
Mailing Address - Zip Code:14843-1614
Mailing Address - Country:US
Mailing Address - Phone:607-324-5141
Mailing Address - Fax:607-324-5141
Practice Address - Street 1:36 GENESEE ST
Practice Address - Street 2:
Practice Address - City:HORNELL
Practice Address - State:NY
Practice Address - Zip Code:14843-1614
Practice Address - Country:US
Practice Address - Phone:607-324-5141
Practice Address - Fax:607-324-5141
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-01
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004313-1213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery