Provider Demographics
NPI:1962457747
Name:PODSIADLO, JANEL L (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:JANEL
Middle Name:L
Last Name:PODSIADLO
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:JANEL
Other - Middle Name:L
Other - Last Name:MROZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:20 LOSSON RD STE 105
Mailing Address - Street 2:PARKVIEW PRIMARY CARE PHYSICIANS, PLLC
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14227-2379
Mailing Address - Country:US
Mailing Address - Phone:716-558-7727
Mailing Address - Fax:716-558-7720
Practice Address - Street 1:20 LOSSON ROAD - SUITE 105
Practice Address - Street 2:PARKVIEW PRIMARY CARE PHYSICIANS, PLLC
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14227
Practice Address - Country:US
Practice Address - Phone:716-558-7727
Practice Address - Fax:716-558-7720
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF331783-1363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00026799701OtherEXCELLUS UNIVERA
NY9511803OtherINDEPENDENT HEALTH
NY005603072OtherHEALTH NOW
NY01807258Medicaid
500007438Medicare PIN
NY005603072OtherHEALTH NOW
NYRB2169Medicare PIN