Provider Demographics
NPI:1750645909
Name:MILCZARSKI, KRISTY LYNNE
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:LYNNE
Last Name:MILCZARSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KRISTY
Other - Middle Name:LYNNE
Other - Last Name:ANDREWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:40 CENTRE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-4100
Mailing Address - Country:US
Mailing Address - Phone:716-667-2294
Mailing Address - Fax:716-667-2272
Practice Address - Street 1:40 CENTRE DR
Practice Address - Street 2:SUITE A
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-4100
Practice Address - Country:US
Practice Address - Phone:716-667-2294
Practice Address - Fax:716-667-2272
Is Sole Proprietor?:No
Enumeration Date:2012-07-02
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator