Provider Demographics
NPI:1255693925
Name:KWITEK, MELISSA (BS SPECIAL EDUACTION)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:
Last Name:KWITEK
Suffix:
Gender:F
Credentials:BS SPECIAL EDUACTION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 FRANCIS AVE
Mailing Address - Street 2:
Mailing Address - City:SLOAN
Mailing Address - State:NY
Mailing Address - Zip Code:14212-2363
Mailing Address - Country:US
Mailing Address - Phone:716-895-3008
Mailing Address - Fax:
Practice Address - Street 1:163 FRANCIS AVE
Practice Address - Street 2:
Practice Address - City:SLOAN
Practice Address - State:NY
Practice Address - Zip Code:14212-2363
Practice Address - Country:US
Practice Address - Phone:716-895-3008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-08
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist