Provider Demographics
NPI:1508181371
Name:BRONISZEWSKI, MICHELE L (DOULA)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:L
Last Name:BRONISZEWSKI
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8547 HERTEL RD
Mailing Address - Street 2:
Mailing Address - City:CANASTOTA
Mailing Address - State:NY
Mailing Address - Zip Code:13032-3609
Mailing Address - Country:US
Mailing Address - Phone:315-697-3719
Mailing Address - Fax:
Practice Address - Street 1:8547 HERTEL RD
Practice Address - Street 2:
Practice Address - City:CANASTOTA
Practice Address - State:NY
Practice Address - Zip Code:13032-3609
Practice Address - Country:US
Practice Address - Phone:315-697-3719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-05
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula