Provider Demographics
NPI:1861016545
Name:PIONTEK, AMY (PHD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:
Last Name:PIONTEK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:WASHINGTON UNIVERSITY ST. LOUIS
Mailing Address - Street 2:CAMPUS BOX 1201
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63130
Mailing Address - Country:US
Mailing Address - Phone:314-935-4129
Mailing Address - Fax:
Practice Address - Street 1:HABIF HEALTH AND WELLNESS CENTER
Practice Address - Street 2:6643 SHEPLEY DRIVE
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63105
Practice Address - Country:US
Practice Address - Phone:314-935-4129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-29
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO144275163WC1400X, 163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC1400XNursing Service ProvidersRegistered NurseCollege Health