Provider Demographics
NPI:1790429561
Name:BAKOWSKI, MORGAN ROSE
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:ROSE
Last Name:BAKOWSKI
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 1:9 LOSSON GARDEN DR APT 4
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14227-2328
Mailing Address - Country:US
Mailing Address - Phone:716-803-9836
Mailing Address - Fax:
Practice Address - Street 1:654 COLVIN BLVD
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:NY
Practice Address - Zip Code:14217-2825
Practice Address - Country:US
Practice Address - Phone:716-447-9128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-26
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program