Provider Demographics
NPI:1942591342
Name:KRAWCZYK, MARY JANE (LPN)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:JANE
Last Name:KRAWCZYK
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22B PIONEER LN
Mailing Address - Street 2:
Mailing Address - City:DELEVAN
Mailing Address - State:NY
Mailing Address - Zip Code:14042-9516
Mailing Address - Country:US
Mailing Address - Phone:716-707-2008
Mailing Address - Fax:
Practice Address - Street 1:700 W STATE ST
Practice Address - Street 2:
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-2346
Practice Address - Country:US
Practice Address - Phone:716-373-9755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-20
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY272910-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse