Provider Demographics
NPI:1831670066
Name:PIECHOTA, RENEE EILEEN
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:EILEEN
Last Name:PIECHOTA
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 1:110 BRADLEY DR
Mailing Address - Street 2:
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760-3948
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3968 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:SCIO
Practice Address - State:NY
Practice Address - Zip Code:14880-9507
Practice Address - Country:US
Practice Address - Phone:585-593-5510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-26
Last Update Date:2018-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP008823224Z00000X
NY009458-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant