Provider Demographics
NPI:1407250558
Name:KULCZYK, ANGEL
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:
Last Name:KULCZYK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 PENNSYLVANIA ST
Mailing Address - Street 2:LOWER
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14201-1711
Mailing Address - Country:US
Mailing Address - Phone:716-906-4203
Mailing Address - Fax:
Practice Address - Street 1:254 PENNSYLVANIA ST
Practice Address - Street 2:LOWER
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14201-1711
Practice Address - Country:US
Practice Address - Phone:716-906-4203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-17
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator