Provider Demographics
NPI:1598792954
Name:LUMMEL-PIWKO, RENEE ANN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:ANN
Last Name:LUMMEL-PIWKO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:
Other - Last Name:LUMMEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4591 SOUTHWESTERN BLVD
Mailing Address - Street 2:BUILDING S APT. #1
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-1946
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4591 SOUTHWESTERN BLVD
Practice Address - Street 2:BUILDING S APT. #1
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-1946
Practice Address - Country:US
Practice Address - Phone:716-632-6420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026584225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist